INTEGRAMED AMERICA INC
10-Q, 1998-05-14
OFFICES & CLINICS OF DOCTORS OF MEDICINE
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                                  UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION
                             WASHINGTON, D.C. 20549


                                    FORM 10-Q

              [X] QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d)
                     OF THE SECURITIES EXCHANGE ACT OF 1934

                  For the quarterly period ended March 31, 1998

                                       OR

             [ ] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d)
                     OF THE SECURITIES EXCHANGE ACT OF 1934

                        For the transition period from to

                           Commission File No. 0-20260
                           Commission File No. 1-11440

                            INTEGRAMED AMERICA, INC.
             (Exact name of Registrant as specified in its charter)


                                    Delaware
         (State or other jurisdiction of incorporation or organization)


                             One Manhattanville Road
                               Purchase, New York
                    (Address of principal executive offices)
                                   06-1150326
                      (I.R.S. employer identification no.)



                                      10577
                                   (Zip code)


                                 (914) 253-8000
              (Registrant's telephone number, including area code)


         Indicate by check mark whether the Registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the  Securities  Exchange  Act of
1934  during  the  preceding  12 months  (or for such  shorter  period  that the
Registrant was required to file such reports),  and (2) has been subject to such
filing requirements for the past 90 days.

              
                                 No [ ]   Yes [X]

         The aggregate number of shares of the Registrant's  Common Stock,  $.01
par value, outstanding on May 1, 1998 was 21,344,423.

================================================================================

<PAGE>



                            INTEGRAMED AMERICA, INC.
                                    FORM 10-Q

                                TABLE OF CONTENTS

                                                                           PAGE

PART I  -        FINANCIAL INFORMATION

    Item 1.      Financial Statements

                   Consolidated Balance Sheet at March 31, 1998 (unaudited)
                     and December 31, 1997....................................3

                   Consolidated Statement of Operations for the three-month
                     period ended March 31, 1998 and 1997 (unaudited).........4

                   Consolidated Statement of Cash Flows for the three-month
                     period ended March 31, 1998 and 1997 (unaudited).........5

                   Notes to Consolidated Financial Statements (unaudited)...6-14

    Item 2.      Management's Discussion and Analysis of Financial Condition and
                     Results of Operations.................................15-18

    Item 3.      Quantitative and Qualitative Disclosures About Market Risk...18


PART II -        OTHER INFORMATION

    Item 1.      Legal Proceedings............................................19

    Item 2.      Changes in Securities........................................19

    Item 3.      Defaults upon Senior Securities..............................19

    Item 4.      Submission of Matters to a Vote of Security Holders..........19

    Item 5.      Other Information............................................19

    Item 6.      Exhibits and Reports on Form 8-K.............................19


SIGNATURES              ......................................................20

INDEX TO EXHIBITS..........................................................21-22


                                        2

<PAGE>



PART I  -  FINANCIAL INFORMATION
    Item 1.      Consolidated Financial Statements
<TABLE>

                            INTEGRAMED AMERICA, INC.
                           CONSOLIDATED BALANCE SHEET
                           (all dollars in thousands)
                                     ASSETS
<CAPTION>
                                                                                           March 31,            December 31,
                                                                                           ---------            ------------
                                                                                             1998                   1997
                                                                                           ---------            ------------
                                                                                          (unaudited)
Current assets:
<S>                                                                                        <C>                     <C>    
  Cash and cash equivalents ..........................................................     $ 2,379                 $ 1,930
  Patient accounts receivable, less allowance for doubtful accounts of $216 and $180
    in 1998 and 1997, respectively....................................................      10,785                   7,061
 Management fees receivable, less allowance for doubtful accounts of $261 and $214
    in 1998 and 1997, respectively....................................................       2,049                   1,600
  Other current assets ...............................................................       2,500                   1,757
                                                                                           -------                 -------
      Total current assets............................................................      17,713                  12,348
                                                                                           -------                 -------
  Fixed assets, net ..................................................................       5,366                   4,742
  Intangible assets, net..............................................................      25,243                  18,445
  Other assets........................................................................         558                     566
                                                                                           -------                 -------
      Total assets....................................................................     $48,880                 $36,101
                                                                                           =======                 =======
                      LIABILITIES AND SHAREHOLDERS' EQUITY
Current liabilities:
  Accounts payable....................................................................     $   340                 $ 1,475
  Accrued liabilities.................................................................       3,829                   2,260
  Due to Medical Practices (see Note 2)...............................................       2,200                   1,745
  Dividends accrued on Preferred Stock................................................         497                     464
  Current portion of exclusive management rights obligation...........................         472                     472
  Note payable and current portion of long-term debt..................................       1,900                     614
  Patient deposits ...................................................................       1,370                   1,236
                                                                                           -------                 -------
      Total current liabilities.......................................................      10,608                   8,266
                                                                                           -------                 -------
Exclusive management rights obligation................................................       1,391                   1,391
Long-term debt .......................................................................       3,696                     451
Commitments and Contingencies.........................................................        --                      --
Shareholders' equity
  Preferred Stock, $1.00 par value -
    3,165,644  shares  authorized  in 1998 and 1997,  respectively  -  2,500,000
    undesignated;  665,644 shares designated as Series A Cumulative  Convertible
    of which 165,644 shares were issued and outstanding in 1998 and
    1997, respectively................................................................         166                     166
  Common Stock, $.01 par value - 25,000,000 shares authorized; 21,344,423 and
    17,198,616 shares issued and outstanding in 1998 and 1997, respectively...........         213                     172
  Capital in excess of par ...........................................................      53,412                  46,471
  Accumulated deficit ................................................................     (20,606)                (20,816)
                                                                                           -------                 -------
      Total shareholders' equity .....................................................      33,185                  25,993
                                                                                           -------                 -------
      Total liabilities and shareholders' equity......................................     $48,880                 $36,101
                                                                                           =======                 =======

        See accompanying notes to the consolidated financial statements.

</TABLE>
                                        3

<PAGE>

<TABLE>


                            INTEGRAMED AMERICA, INC.
                      CONSOLIDATED STATEMENT OF OPERATIONS
              (all amounts in thousands, except per share amounts)

<CAPTION>

                                                                                        For the
                                                                                   three-month period
                                                                                     ended March 31,
                                                                                   ------------------
                                                                                    1998        1997
                                                                                   ------      ------
                                                                                       (unaudited)

<S>                                                                               <C>         <C>   
Revenues, net (see Note 2).................................................        $8,746      $4,692

Operating expenses incurred on behalf of Network Sites:
   Employee compensation...................................................         3,731       1,866
   Direct materials........................................................           785         304
   Occupancy costs.........................................................           714         417
   Depreciation............................................................           311         207
   Other expenses..........................................................         1,468         821
                                                                                   ------      ------
   Total operating expenses incurred on behalf of Network Sites............         7,009       3,615
                                                                                   ------      ------
Network Sites' contribution................................................         1,737       1,077
General and administrative expenses........................................         1,185         977
Amortization of intangible assets..........................................           233         137
Interest income............................................................           (12)        (34)
Interest expense...........................................................            72          10
                                                                                   ------      ------
Total other expenses.......................................................         1,478       1,090
                                                                                   ------      ------
Income (loss) before income taxes..........................................           259         (13)
Provision for income taxes.................................................            49          32
                                                                                   ------      ------
Net income (loss)..........................................................           210         (45)
Less: Dividends accrued on Preferred Stock.................................            33          33
                                                                                   ------      ------
Net income (loss) applicable to Common Stock...............................         $ 177      $  (78)
                                                                                   ======      ======
Basic earnings (loss) per share of Common Stock............................         $0.01      $(0.01)
                                                                                   ======      ======
Diluted earnings (loss) per share of Common Stock..........................         $0.01      $(0.01)
                                                                                   ======      ======
Weighted average shares - basic............................................        20,024       9,544
                                                                                   ======      ======
Weighted average shares - diluted..........................................        20,401       9,544
                                                                                   ======      ======

</TABLE>

        See accompanying notes to the consolidated financial statements.


                                        4

<PAGE>

<TABLE>


                            INTEGRAMED AMERICA, INC.
                      CONSOLIDATED STATEMENT OF CASH FLOWS
                           (all amounts in thousands)
<CAPTION>
                                                                                            For the
                                                                                     three-month period
                                                                                       ended March 31,
                                                                                    ---------------------
                                                                                      1998          1997
                                                                                    -------       -------
                                                                                         (unaudited)
Cash flows from operating activities:
<S>                                                                                  <C>           <C>    
  Net income (loss) ..........................................................       $ 210         $  (45)
  Adjustments to reconcile net income (loss) to net cash used in operating activities:
   Depreciation and amortization..............................................         581            417
   Writeoff of fixed and other assets ........................................          37             55
   Changes in assets and liabilities-- (Increase) decrease in assets:
        Patient accounts receivable...........................................      (2,384)          (277)
        Management fees receivable............................................        (449)          (508)
        Other current assets..................................................        (701)           (96)
        Other assets..........................................................           8             (5)
     Increase (decrease) in liabilities:
         Accounts payable.....................................................       (1,435)         (445)
         Accrued liabilities..................................................           86          (377)
         Due to Medical Practices.............................................          455           102
         Patient deposits.....................................................          (78)           91
                                                                                     ------        ------
   Net cash used in operating activities......................................       (3,670)       (1,088)
                                                                                     ------        ------

  Cash flows (used in) provided by investing activities:
     Proceeds from short term investments.....................................         --           2,000
     Purchase of net liabilities (assets) of acquired businesses..............          487           (29)
     Payments for exclusive management rights and related acquisition costs...       (3,109)       (1,635)
     Purchase of fixed assets and leasehold improvements......................         (438)          (64)
     Proceeds from sale of fixed assets.......................................         --              80
                                                                                     ------        ------
  Net cash (used in) provided by investing activities.........................       (3,060)          352
                                                                                     ------        ------

  Cash flows provided by (used in) financing activities:
     Proceeds from issuance of Common Stock...................................        5,500          --
     Used for stock issue costs...............................................          (61)         --
     Proceeds from bank under Credit Facility.................................        2,000           250
     Principal repayments on debt.............................................         (286)          (52)
     Principal repayments under capital lease obligations.....................          (36)          (27)
     Proceeds from exercise of Common Stock options...........................           62            14
                                                                                     ------        ------
Net cash provided by financing activities.....................................        7,179           185
                                                                                     ------        ------

Net increase (decrease) in cash and cash equivalents..........................          449          (551)
Cash and cash equivalents at beginning of period..............................        1,930         3,952
                                                                                     ------        ------

Cash and cash equivalents at end of period....................................       $2,379        $3,401
                                                                                     ======        ======
</TABLE>

        See accompanying notes to the consolidated financial statements.




                                        5

<PAGE>



                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                                   (unaudited)

NOTE 1 -- INTERIM RESULTS:

     The  accompanying  unaudited  consolidated  financial  statements have been
prepared in accordance with the instructions to Form 10-Q and,  accordingly,  do
not include all of the information and footnotes  required by generally accepted
accounting  principles  for  complete  financial  statements.  In the opinion of
management,  the accompanying unaudited interim financial statements contain all
adjustments  (consisting only of normal recurring accruals) necessary to present
fairly the financial  position at March 31, 1998,  and the results of operations
and cash flows for the  interim  period  presented.  Operating  results  for the
interim  period are not  necessarily  indicative of results that may be expected
for the year ending December 31, 1998. These financial statements should be read
in conjunction  with the financial  statements and notes thereto included in the
Company's Annual Report on Form 10-K for the year ended December 31, 1997.

NOTE 2 -- SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES:

   Basis of consolidation --

     The consolidated  financial  statements comprise the accounts of IntegraMed
America,  Inc. and its wholly owned  subsidiaries,  IVF America (NY),  Inc., IVF
America (MA),  Inc., IVF America (PA), Inc., IVF America (NJ), Inc., IVF America
(MI), Inc., IntegraMed America of Illinois, Inc., Shady Grove Fertility Centers,
Inc. (see Note 6) and the Adult  Women's  Medical  Center,  Inc.  ("AWMC").  All
significant intercompany transactions have been eliminated.  The Company derives
its revenues from management agreements and, with respect to one managed Network
Site and AWMC, from patient service  revenues.  The Company does not consolidate
the results of its managed Network Sites.

     In  1997,  the  Emerging  Issues  Task  Force of the  Financial  Accounting
Standards  Board (the "EITF") issued EITF No. 97-2. The EITF reached a consensus
concerning certain matters relating to the physician practice management ("PPM")
industry with respect to the consolidation of professional  corporation revenues
and the  accounting  for  business  corporations.  As an interim step before the
consensus, the EITF allowed PPMs to display the revenues and expenses of managed
physician  practices in the statement of operations  (the  "alternative  display
method") if the terms of the management  agreement  provided the PPM with a "net
profits or  equivalent  interest"  in the net  profits of the  medical  services
furnished by the Medical Practices.  It is the Company's  understanding that the
EITF did not and would not object to the use of the  alternative  display method
in PPM financial  statements for periods ending before December 15, 1998. As the
Company does not  consolidate  its managed  Network Sites,  the adoption of EITF
97-2  in 1998  does  not  have a  material  impact  on the  Company's  financial
position,  cash flows or results of operations.  As discussed below, the Company
has  discontinued the display of revenues for its Long Island and Boston Network
Sites due to changes in the respective management agreements.

     Since  inception  through  December 31,  1997,  the  management  agreements
related to the Long Island and Boston  Network Sites have been  incorporated  in
the Company's  consolidated  financial  statements via the display method as the
Company  believed  that  these  management  agreements  provided  it with a "net
profits or  equivalent  interest"  in the net  profits of the  medical  services
furnished by the Medical  Practices at the Long Island and Boston Network Sites.
Consequently,  for the Long  Island and Boston  Network  Sites,  the Company has
historically  presented the Medical  Practices'  patient services revenue,  less
amounts retained by the Medical Practices,  or "Medical Practice retainage",  as
"Revenues after Medical  Practice  retainage" in its  consolidated  statement of
operations  ("display  method").  Due to changes in the terms of the  management
agreements  related to the Long Island and Boston  Network  Sites,  effective in
October 1997 and January 1998, respectively,  the Company no longer displays the
patient services revenue of the Long Island and Boston Medical  Practices.  As a
result,  the Company no longer displays the patient services revenue and Medical
Practice   retainage   related  to  these  Network  Sites  in  the  accompanying
consolidated  statement of operations  for the periods prior to January 1, 1998.
The revised management  agreements provide for the Company to receive a specific
management  fee  which  the  Company  has  reported  in  "Revenues,  net" in the
accompanying consolidated statement of operations.

     These  consolidated  financial  statements are prepared in accordance  with
generally accepted accounting  principles which requires the use of management's
estimates. The preparation of financial statements in conformity with generally

                                        6

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

accepted  accounting  principles  requires  management  to  make  estimates  and
assumptions  that  affect the  reported  amounts of assets and  liabilities  and
disclosure of  contingent  assets and  liabilities  at the date of the financial
statements  and the  reported  amounts  of  revenues  and  expenses  during  the
reporting period. Actual results could differ from those estimates.

   Revenue and cost recognition -

   Reproductive Science Center Division ("RSC Division")

     During  the first  quarter  of 1998,  the RSC  Division's  operations  were
comprised  of eleven  management  agreements,  one of which was entered  into in
mid-March 1998.

     Under eight of the agreements,  including the revised management  agreement
for the Boston  Network  Site,  the  Company  receives as  compensation  for its
management  services  a  three-part  management  fee  comprised  of: (i) a fixed
percentage  of net  revenues  generally  equal to 6%,  (ii)  reimbursed  cost of
services  (costs  incurred in managing a Medical  Practice and any costs paid on
behalf of the  Medical  Practice)  and (iii) a fixed or variable  percentage  of
earnings after management fees and any guaranteed physician compensation,  or an
additional fixed or variable  percentage of net revenues which generally results
in the Company  receiving up to an additional  9.5% of net  revenues.  Under the
revised  management  agreement for the Long Island Network Site, as compensation
for its management  services,  the Company receives a fixed fee (currently equal
to $525,000 per annum), plus reimbursed costs of services.

     Two of the Company's  Network Sites are  affiliated  with medical  centers.
Under  one of  these  management  agreements,  the  Company  primarily  provides
endocrine testing and administrative and finance services for a fixed percentage
of revenues,  equal to 15% of net revenues,  and  reimbursed  costs of services.
Under the second of these  management  agreements,  the  Company's  revenues are
derived from certain ART laboratory services  performed,  and directly billed to
the patients by the Company; out of these patient service revenues,  the Company
pays its direct costs and the remaining balance represents the Company's Network
Site  contribution.  All direct  costs  incurred by the Company are  recorded as
costs of services.

     All management fees are reported as "Revenues,  net" by the Company. Direct
costs incurred by the Company in performing  its  management  services and costs
incurred on behalf of the Medical  Practices are recorded in operating  expenses
incurred on behalf of Network Sites. The physicians  receive as compensation all
remaining earnings after payment of the Company's management fee.

     Prior to January 1, 1998, under another form of management  agreement which
had been in use at the  Long  Island  and  Boston  Network  Sites,  the  Company
recorded all patient  service  revenues and, out of such  revenues,  the Company
paid  the  Medical   Practices'   expenses,   physicians'   and  other   medical
compensation, direct materials and certain hospital contract fees. Specifically,
under  the  management  agreement  for the  Boston  Network  Site,  the  Company
guaranteed a minimum  physician  compensation  based on an annual budget jointly
determined by the Company and the physicians.  Remaining revenues, if any, which
represented  the Company's  management  fees, were used by the Company for other
direct administrative  expenses which were recorded as costs of services.  Under
the  management  agreement  for the Long  Island  Network  Site,  the  Company's
management  fee was payable only out of remaining  revenues,  if any,  after the
payment of all expenses of the Medical Practice.  Under these arrangements,  the
Company had been liable for payment of all  liabilities  incurred by the Medical
Practices and had been at risk for any losses incurred in the operation thereof.
Due to  changes in the  management  agreements  related  to the Long  Island and
Boston Network Sites, effective in October 1997 and January 1998,  respectively,
the Company no longer displays  patient service  revenues of the Long Island and
Boston  Medical  Practices  which had been  reflected in "Revenues,  net" in the
Company's   consolidated   statement  of  operations.   The  revised  management
agreements  provide for the Company to receive a specific  management  fee which
the Company  will report in  "Revenues,  net" in its  consolidated  statement of
operations.  Under the revised management  agreement for the Long Island Network
Site, as compensation for its management services,  the Company receives a fixed
fee (currently equal to $525,000 per annum),  plus reimbursed costs of services.
Under  the  revised  management  agreement  for  the  Boston  Network  Site,  as
compensation  for its  management  services,  the Company  receives a three-part
management fee consistent with the majority of the Company's existing management
agreements.   The  revised  agreements  provide  for  increased  incentives  and
risk-sharing for the Company's affiliated medical providers.


                                        7

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

   AWM Division

     The AWM Division's  operations are currently  comprised of one Network Site
with two locations which are directly owned by the Company and a 51% interest in
the National Menopause Foundation ("NMF"), a company which develops multifaceted
educational  programs  regarding  women's  healthcare.  The Network Site is also
involved in clinical trials with major pharmaceutical companies.

     The Company bills and records all patient  service  revenues of the Network
Site and records all direct  costs  incurred as costs of  services.  The Company
retains as Network Site  contribution an amount  determined using the three-part
management fee calculation described above with regard to the RSC Division,  and
the balance is paid as compensation to the medical  providers and is recorded by
the Company in costs of services rendered. The medical providers receive a fixed
monthly  draw  which  may be  adjusted  quarterly  by the  Company  based on the
respective Network Site's actual operating results.

     Revenues in the AWM Division also include  amounts  earned under  contracts
relating to clinical trials between the Network Site and various  pharmaceutical
companies.  The  Network  Site  contracts  with major  pharmaceutical  companies
(sponsors)  to perform  women's  medical care  research  mainly to determine the
safety and efficacy of a medication.  Research revenues are recognized  pursuant
to each  respective  contract  in the  period  which the  medical  services  (as
stipulated by the research study  protocol) are performed and collection of such
fees is considered probable. Net realization is dependent upon final approval by
the sponsor that procedures were performed according to study protocol. Payments
collected  from  sponsors  in  advance  for  services  are  included  in accrued
liabilities,  and costs incurred in performing the research studies are included
in costs of services rendered.

     The Company's 51% interest in NMF is included in the Company's consolidated
financial  statements.  The Company records 100% of the patient service revenues
and costs of NMF and reports  49% of any profits of NMF as minority  interest on
the Company's  consolidated  balance sheet.  Minority interest at March 31, 1998
and December 31, 1997 was $0.

   Patient accounts receivable--

     Patient accounts receivable represent receivables from patients for medical
services  provided by the Medical  Practices.  Such  amounts are recorded net of
contractual  allowances  and  estimated  bad  debts.  As of March  31,  1998 and
December 31, 1997,  of total  patient  accounts  receivable of $10.8 million and
$7.1  million,  respectively,  approximately  $10.3  million and $4.5 million of
patient  accounts  receivable were a function of Network Site revenue (i.e., the
Company  purchased  the  accounts  receivable  from the  Medical  Practice  (the
"Purchased  Receivables"))  and the  remaining  balances  of  $514,000  and $2.6
million,  respectively,  were a function of net  revenues of the Company (see --
"Revenue  and  cost  recognition"  above).  Risk  of  loss  in  connection  with
non-collectiblity of Purchased  Receivables is partially borne by the Company in
an amount  generally equal to the percentage of revenues and/or earnings paid to
the Company from the Medical  Practice as its  management  fee.  Risk of loss in
connection with  non-collectibility  of patient accounts  receivable which are a
function of net revenues of the Company is borne by the Company.

   Management fees receivable --

     Management fees receivable  represent fees owed to the Company  pursuant to
its management  agreements with certain  Medical  Practices (see -- "Revenue and
cost recognition" above).

   Research fees receivable --

     Research  fees  receivable   represent   receivables  from   pharmaceutical
companies for medical services  provided by the Medical Practices at the Network
Site under the AWM Division to patients  pursuant to protocols  stipulated under
contracts relating to clinical trials between the  pharmaceutical  companies and
the AWM Division.



                                        8

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

     Intangible assets --

         Intangible  assets at March 31, 1998 and December 31, 1997 consisted of
the following (000's omitted):

                                              March 31,     December 31, 
                                             ----------     ------------
                                               1998             1997
                                             ----------     ------------

     Exclusive management rights...........   $22,793          $15,539
     Goodwill..............................     3,667            3,890
     Trademarks............................       395              395
                                              -------          -------
          Total............................    26,855           19,824
     Less-- accumulated amortization.......    (1,612)          (1,379)
                                              -------          -------
          Total............................   $25,243          $18,445
                                              =======          =======

   Exclusive Management Rights, Goodwill and Other Intangible Assets

     Exclusive management rights, goodwill and other intangible assets represent
costs  incurred by the Company for the right to manage  and/or  acquire  certain
Network Sites and are valued at cost less accumulated amortization.

   Trademarks

     Trademarks  represent  trademarks,  service  marks,  trade  names and logos
purchased by the Company and are valued at cost less accumulated amortization.

   Amortization and recoverability

     The  Company   periodically   reviews  its  intangible   assets  to  assess
recoverability;   any  impairments  would  be  recognized  in  the  consolidated
statement  of  operations  if a permanent  impairment  were  determined  to have
occurred.  Recoverability  of  intangibles is determined  based on  undiscounted
expected  earnings from the related business unit or activity over the remaining
amortization period.  Exclusive management rights are amortized over the term of
the respective management agreement,  usually ten to twenty-five years. Goodwill
and other  intangibles  are amortized  over periods  ranging from three to forty
years.   Trademarks  are  amortized  over  five  to  seven  years.   Accumulated
amortization  of  exclusive  management  rights,  goodwill  and  trademarks  was
$973,000,  $334,000  and  $305,000  at March  31,  1998,  respectively,  and was
$802,000, $283,000 and $294,000 at December 31, 1997, respectively.

   Due to Medical Practices --

     Due to Medical Practices  primarily  represents amounts owed by the Company
to the Medical  Practices  for the medical  providers'  share of the  respective
Medical Practice earnings net of the Company's advances to the Medical Practice,
if any. Due to Medical Practices excludes amounts owed by the Company to Medical
Practices for exclusive management rights.

Earnings per share --

     The  Company  determines  earnings  (loss)  per  share in  accordance  with
Financial Accounting Standards No. 128, "Earnings Per Share" (FAS 128) which the
Company adopted in December 1997. All historical  earnings (loss) per share have
been presented in accordance with FAS 128.



                                        9

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

NOTE 3 -- REVENUES AND NETWORK SITES' CONTRIBUTION:

     The  following  table sets forth for the three  months ended March 31, 1998
and  1997,  Revenues,  net  and  Network  Sites'  contribution  for  each of the
Company's  four  types of  management  agreements  (three-part  management  fee,
percent  of  revenues  plus  reimbursed  operating  expenses,   fixed  fee  plus
reimbursed operating expenses,  and patient service revenues) and Revenues,  net
and Network Sites' contribution for the AWM Division (000's omitted):
<TABLE>
<CAPTION>
                                                                                    For the
                                                                              three-month period
                                                                                ended March 31,
                                                                              -------------------
                                                                               1998         1997
                                                                              ------       ------
Revenues, net:
<S>                                                                           <C>          <C>   
   RSC Division --
     Management fees-- three-part management fee (1).......................   $6,305       $1,176
     Management fees-- percent of revenues plus reimbursed operating
       expenses of the New Jersey Network Site.............................    1,002          879
     Management fees-- fixed fee plus reimbursed operating expenses for
       the Long Island Network Site (2)....................................      791         --
     Patient service revenues (1), (2).....................................      242        1,969
                                                                              ------       ------
         Total RSC Division................................................    8,340        4,024
   AWM Division............................................................      406          668
                                                                              ------       ------
         Total revenues, net...............................................   $8,746       $4,692
                                                                              ======       ======

Network Sites' contribution
   RSC Division  --
       Management fees.....................................................   $1,866       $  536
       Patient service revenues............................................       35          470
                                                                              ------       ------
         Total RSC Division................................................    1,901        1,006
                                                                              ------       ------
   AWM Division............................................................     (164)          71
                                                                              ------       ------
         Total Network Sites' contribution.................................   $1,737       $1,077
                                                                              ======       ======

   (1) Historically,  revenues  from the Boston  Network Site have  consisted of
       patient service  revenues.  Effective  January 1, 1998, due to changes in
       the management  agreement  related to the Boston  Network Site,  revenues
       from this site consist of a three-part management fee.

   (2) Historically,  revenues from the Long Island  Network Site have consisted
       of patient service revenues. Effective October 1, 1997, due to changes in
       the  management  agreement  related  to the  Long  Island  Network  Site,
       revenues from this site consist of a fixed management fee plus reimbursed
       cost of services.

</TABLE>


                                       10

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

     For the three months ended March 31, 1998 and 1997, the FCI, Boston and New
Jersey Network Sites provided  greater than 10% of the Company's  Revenues,  net
and Network Sites' contribution as follows:
<TABLE>
<CAPTION>

                                                     Percent of Company             Percent of Network
                                                        Revenues, net               Sites' contribution
                                                     for the three-month            for the three-month
                                                   period ended March 31,          period ended March 31,
                                                   ----------------------          ----------------------
                                                    1998            1997            1998            1997
                                                   -----            -----          -----            -----
    <S>                                           <C>              <C>              <C>             <C>
     FCI.......................................    28.70%            N/A            35.81%           N/A
     Boston....................................    16.82%           29.76%          25.56%          38.25%
     New Jersey................................    11.46%           18.74%          31.89%          49.21%
</TABLE>

NOTE 4 -- NOTE PAYABLE:

     In November  1996,  the Company  obtained a $1.5 million  revolving  credit
facility  (the  "Credit  Facility")  issued by First  Union  National  Bank (the
"Bank").  Borrowings under the Credit Facility bear interest at the Bank's prime
rate plus  0.75% per  annum,  which at March 31,  1998,  was  9.25%.  The Credit
Facility  terminates on July 1, 1998 and is secured by the Company's  assets. At
March 31,1998 and December 31, 1997,  $1.5 million and  $250,000,  respectively,
were outstanding under the Credit Facility.

     On November 13, 1997, the Company entered into a $4.0 million non-restoring
line of  credit  dated  November  13,  1997 with the Bank  (the  "Second  Credit
Facility").  Borrowings  under the Second  Credit  Facility bear interest at the
Bank's prime rate plus 1% per annum.  Accrued  interest  only on  borrowings  is
payable  commencing  December 1, 1997 and all principal and accrued  interest is
due and  payable  on  April  30,  1999.  The  Second  Credit  Facility  is cross
collateralized  and  cross-defaulted  with the Credit Facility and is secured by
the Company's assets.  As of March 31, 1998 and December 31, 1997,  $750,000 and
$0, respectively, were outstanding under the Second Credit Facility.

     As part  consideration  for the  acquisition  of the capital stock of Shady
Grove  Fertility  Centers,  Inc.,  the Company issued $1.1 million in promissory
notes which are payable in two equal annual  installments,  due on April 1, 1999
and  2000,  respectively,  and bear  interest  at an annual  rate of 8.5%.  Also
included in notes payable is  approximately  $1.5 million which  represents  the
amount owed by the Company to acquire the balance of the capital  stock of Shady
Grove Fertility Centers, Inc., on or about November 1, 1998 (see Note 6).

NOTE 5 -- EQUITY:

     During the first quarter of 1998, the Company consummated an equity private
placement of $5.5 million with entities  affiliated  with Morgan Stanley Venture
Partners  providing for the purchase of 3,235,294 shares of the Company's Common
Stock at a price of $1.70 per share and 240,000  warrants to purchase  shares of
the Company's  Common Stock, at a nominal  exercise  price.  The Company used or
will use approximately half of these funds to acquire the capital stock of Shady
Grove Fertility Centers, Inc.

     In March and April 1998,  pursuant to amendments  to the Bay Area,  FCI and
Shady Grove  management  agreements,  the Company issued warrants to purchase an
aggregate of 150,000  shares of Common  Stock,  at a weighted  average  exercise
price of $1.77 per share to the shareholder physicians of the respective medical
practices in exchange for an extension of the term of the  Company's  respective
management agreements from twenty to twenty-five years.

NOTE 6 -- RECENT ACQUISITIONS:

     In January 1998, the Company completed its second in-market merger with the
addition of two  physicians to the FCI practice.  The Company  acquired  certain
assets of Advocate  Medical  Group,  S.C.  ("AMG") and  Advocate  MSO,  Inc. and
acquired the right to manage AMG's infertility practice conducted under the name
Center for Reproductive Medicine ("CFRM"). Simultaneous with the consummation of
this  transaction,  the Company  amended its  management  agreement  with FCI to
include  two of the  three  physicians  practicing  under  the  name  CFRM.  The


                                       11

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

aggregate  purchase  price  was  approximately   $1.5  million,   consisting  of
approximately  $1.2  million in cash and  184,314  shares of Common  Stock.  The
majority of the purchase price was allocated to exclusive management rights.

      On March 12, 1998, the Company  acquired the majority of the capital stock
of Shady Grove Fertility  Centers,  Inc. ("Shady  Grove"),  currently a Maryland
business corporation which provides management services, and formerly a Maryland
professional corporation engaged in providing infertility services. Prior to the
consummation  of the  transaction,  Shady Grove had entered  into a  twenty-year
management  agreement with Levy, Sagoskin and Stillman,  M.D., P.C. (the " Shady
Grove  P.C."),  an  infertility   physician  group  practice  comprised  of  six
physicians and four locations surrounding the greater Washington, D.C. area. The
Company  will acquire the balance of the Shady Grove  capital  stock on or about
November  1,  1998.  The  aggregate  purchase  price for all of the Shady  Grove
capital stock was approximately  $5.7 million,  consisting of approximately $2.8
million in cash,  $1.4 million in Common  Stock,  and $1.5 million in promissory
notes.  The purchase price was allocated to the various  assets and  liabilities
assumed and the balance was allocated to exclusive  management  rights. On March
12,  1998,  the  Closing  Date,  the  following   consideration  was  paid:  (i)
approximately  $1.8 million in cash, (ii) approximately $1.2 million in stock or
639,551  shares of  Common  Stock,  and  (iii)  approximately  $1.1  million  in
promissory  notes.  The Company will pay the balance of the  aggregate  purchase
price on or about November 1, 1998 (the "Second Closing Date"), when the balance
of the Shady Grove capital stock is transferred to the Company. The $1.1 million
of  promissory  notes  currently  outstanding  are  payable in two equal  annual
installments due on April 1, 1999 and 2000,  respectively,  and bear interest at
an annual  rate of 8.5%.  The  number of shares of  Company  Common  Stock to be
issued on the  Second  Closing  Date,  which  will have a fair  market  value of
approximately  $200,000, will be determined based upon the average closing price
of the Company's  Common Stock for the ten-day trading period prior to the third
business day before the Second Closing Date, provided, however, that in no event
will the price per share exceed $2.00 or be less than $1.70 for purposes of this
calculation.

     The following unaudited pro forma results of operations for the three-month
periods ended March 31, 1998 and 1997 have been prepared by management  based on
the unaudited financial  information for Shady Grove, the Maryland  professional
corporation,  which  management  arrangement was entered into in March 1998, and
Fertility Centers of Illinois,  S.C. which management agreement was entered into
in August  1997,  adjusted  where  necessary,  with  respect to  pre-acquisition
periods, to the basis of accounting used in the historical  financial statements
of the  Company.  Such  adjustments  include  modifying  the  results to reflect
operations as if the Shady Grove  management  agreement had been  consummated on
January 1, 1998 and 1997,  respectively,  and as if the FCI management agreement
had been consummated on January 1, 1997.  Additional  general corporate expenses
which  would have been  required to support  the  operations  of the new Network
Sites are not included in the pro forma results. The unaudited pro forma results
may not be indicative of the results that would have occurred if the  management
agreement had been in effect on the dates  indicated or which may be obtained in
the future.
                                                         For the three-month
                                                       periods ended March 31,
                                                           (000's omitted)
                                                       -----------------------
                                                          1998          1997
                                                       ---------      --------
                                                              (unaudited)

Revenues, net.........................................  $10,265        $7,136
Income before income taxes (1)........................  $   477        $  297
Net income............................................  $   388        $  230
Basic earnings per share of Common Stock..............  $  0.02        $ 0.02
Diluted earnings per share of Common Stock............  $  0.02        $ 0.02

(1)  Income before income taxes includes  approximately $278,000 and $274,000 of
     amortization of exclusive  management rights and goodwill in 1998 and 1997,
     respectively.



                                       12

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

NOTE 7 -- EARNINGS PER SHARE:

     The  reconciliation  of the  numerators and  denominators  of the basic and
diluted EPS  computations  for the three-month  periods ended March 31, 1998 and
1997 is as follows (000's omitted, except for per share amounts):
<TABLE>
<CAPTION>

                                                     1998                                 1997
                                    ----------------------------------     ----------------------------------
                                      Income       Shares     Per-Share      Income      Shares     Per-Share
                                    (Numerator) (Denominator)  Amount      (Numerator)(Denominator)  Amount
                                    ----------- -------------  ------      ----------- ------------  ------

<S>                                     <C>          <C>         <C>           <C>         <C>       <C>    
Net income (loss)............           $210                                   $(45)
Less: Preferred stock
   dividends accrued.........            (33)                                   (33)
                                        ----                                   ----


Basic EPS
Income (loss) available to
   Common stockholders.......           $177         20,024      $0.01         $(78)       9,544     $(0.01)
                                        ====         ======      =====         ====        =====     ======

Effect of Dilutive Securities
Options......................            --             168                     --           --

Warrants.....................            --             209                     --           --
                                        ----         ------                    ----        -----

Diluted EPS (1)
Income (loss) available to
Common stockholders + assumed
   conversions...............           $177         20,401      $0.01         $(78)       9,544     $(0.01)
                                        ====         ======      =====         ====        =====     ======
</TABLE>

     Options  to  purchase  1,013,991  shares of Common  Stock and  warrants  to
purchase  367,266  shares of Common Stock at prices  ranging from $2.03 to $3.75
per share and from $9.02 to $10.34 per share, respectively,  were outstanding as
of March 31,  1998 but were not  included  in the  computation  of  diluted  EPS
because the  exercise  price of the options and  warrants  was greater  than the
average market price of the shares of Common Stock.

     For the  three-month  period  ended March 31, 1998,  the 593,006  shares of
Common  Stock from the assumed  conversion  of  Preferred  Stock are excluded in
computing the diluted per share amount as they are antidilutive.

     For the three-month  period ended March 31, 1997, the effect of the assumed
exercise of options to purchase  1,133,783  shares of Common Stock at a weighted
average  exercise  price of $1.86 per share and  warrants  to  purchase  370,377
shares of Common  Stock at prices  ranging  from $1.25 to $13.79 per share,  and
265,030  shares of Common Stock from the assumed  conversion of Preferred  Stock
are excluded in computing the diluted per share amount as they are antidilutive.

NOTE 8 -- SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION AND NON-CASH
         TRANSACTIONS:

     In connection with its acquisition of the exclusive right to manage CFRM in
January  1998,  the  Company  issued  184,314  shares  of Common  Stock  with an
aggregate fair value equal to approximately $300,000.

     In connection  with its  acquisition  of the exclusive  right to manage the
Shady Grove P.C., in March 1998,  the Company  issued  639,551  shares of Common
Stock with an  aggregate  fair value  equal to  approximately  $1.2  million and
approximately  $1.1 million in  promissory  notes.  The Company also recorded an


                                       13

<PAGE>


                            INTEGRAMED AMERICA, INC.
             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (Continued)
                                   (unaudited)

additional debt obligation of  approximately  $1.5 million which  represents the
amount owed to acquire the balance of the capital  stock of Shady  Grove,  which
should occur on or about November 1, 1998.

     In connection  with its  acquisition  of the exclusive  right to manage Bay
Area  Fertility in January 1997,  the Company  issued  333,333  shares of Common
Stock with an aggregate fair value equal to approximately $500,000.

     In March and April 1998,  pursuant to amendments  to the Bay Area,  FCI and
Shady Grove  management  agreements,  the Company issued warrants to purchase an
aggregate  150,000  shares of the Company's  Common Stock at a weighted  average
exercise  price  of  $1.77  per  share  to  the  shareholder  physicians  of the
respective  medical  practices  in exchange  for an extension of the term of the
Company's respective managements agreement from twenty to twenty-five years.

     In the three-month  period ended March 31, 1997, the Company entered into a
capital lease obligation in the amount of $105,000 for medical equipment.

     Accrued dividends on Convertible  Preferred Stock outstanding  increased by
$33,000 to $497,000 and by $33,000 to $364,000, in the three-month periods ended
March 31, 1998 and 1997, respectively.

     State taxes, which primarily reflect various state income taxes, of $76,000
and $2,000 were paid in the  three-month  periods ended March 31, 1998 and 1997,
respectively.

     Interest paid in cash in the  three-month  periods ended March 31, 1998 and
1997  amounted to $72,000 and $11,000,  respectively.  Interest  received in the
three-month  periods  ended  March 31,  1998 and 1997  amounted  to $12,000  and
$34,000, respectively.






                                       14

<PAGE>

Item 2. Management's  Discussion and Analysis of Financial Condition and Results
        of Operations

     The following  discussion and analysis  should be read in conjunction  with
the  consolidated  financial  statements  and  notes  thereto  included  in this
quarterly  report and with the Company's Annual Report on Form 10-K for the year
ended December 31, 1997.

Overview

     During the first quarter of 1998, the Company consummated an equity private
placement of $5.5 million with entities  affiliated  with Morgan Stanley Venture
Partners  providing for the purchase of 3,235,294 shares of the Company's Common
Stock at a price of $1.70 per share and 240,000  warrants to purchase  shares of
the Company's Common Stock, at a nominal exercise price.  Approximately  half of
these funds were or will be used by the Company to purchase the capital stock of
Shady Grove  Fertility  Centers,  Inc.  ("Shady  Grove") and the right to manage
Levy,  Sagoskin and Stillman M.D.,  P.C. (the "Shady Grove P.C.") an infertility
physician  group practice  comprised of six physicians and four locations in the
greater Washington,  D.C. area. The Shady Grove management  agreement represents
the second most significant  management agreement entered into by the Company to
date.

     Since  inception  through  December 31,  1997,  the  management  agreements
related to the Long Island and Boston  Network Sites have been  incorporated  in
the Company's  consolidated  financial  statements via the display method as the
Company  believed  that  these  management  agreements  provided  it with a "net
profits or  equivalent  interest"  in the net  profits of the  medical  services
furnished by the Medical  Practices at the Long Island and Boston Network Sites.
Consequently,  for the Long  Island and Boston  Network  Sites,  the Company has
historically  presented the Medical  Practices'  patient services revenue,  less
amounts retained by the Medical Practices,  or "Medical Practice retainage",  as
"Revenues after Medical  Practice  retainage" in its  consolidated  statement of
operations  ("display  method").  Due to  changes in the  management  agreements
related to the Long Island and Boston  Network  Sites  effective in October 1997
and  January  1998,  respectively,  the Company no longer  displays  the patient
services revenue of the Long Island and Boston Medical  Practices.  As a result,
the Company no longer displays the patient services revenue and Medical Practice
retainage  related  to  these  Network  Sites in the  accompanying  consolidated
statement of operations  for the periods  prior to January 1, 1998.  The revised
management  agreements provide for the Company to receive a specific  management
fee which the  Company  has  reported  in  "Revenues,  net" in the  accompanying
consolidated  statement  of  operations.  The  revised  agreements  provide  for
increased  incentives  and  risk-sharing  for the Company's  affiliated  Medical
Practices.

     The RSC Division  currently  consists of eleven Network  Sites.  During the
three-month  period ended March 31, 1998, the RSC Division  derived its revenues
pursuant to eleven  management  agreements,  including two of which were entered
into  subsequent to the first  quarter in 1997.  During the  three-month  period
ended March 31, 1997, the RSC Division principally derived its revenues pursuant
to eight management agreements.

Results of Operations

 Three Months Ended March 31, 1998 Compared to Three Months Ended March 31, 1997

     Revenues, net for the three months ended March 31, 1998 (the "first quarter
of 1998") were  approximately  $8.7  million as compared to  approximately  $4.7
million for the three months ended March 31, 1997 (the "first quarter of 1997"),
an increase of 86.4%.  In the first quarter of 1998,  the Company's RSC Division
and AWM Division  contributed  95.4% and 4.6%,  respectively,  of the  Company's
total revenues compared to 85.8% and 14.2%,  respectively,  in the first quarter
of 1997.
                                       15

<PAGE>

     RSC Division  revenues  for the first  quarter of 1998 more than doubled to
approximately  $8.3 million as compared to $4.0 million for the first quarter of
1997.  For the first quarter of 1998,  revenues at Network Sites existing in the
comparable  period  in 1997  increased  by  28.1%,  due to  increases  in volume
primarily  attributable  to new  service  offerings  at certain  Network  Sites.
Revenues  under the RSC Division  were  comprised of (i)  three-part  management
fees,  (ii)  management  fees based on a percentage  of revenues and  reimbursed
costs of services,  (iii)  management  fees based on a fixed fee plus reimbursed
costs of services, and (iv) patient service revenues. Three- part management fee
revenues were  approximately  $6.3 million in the first quarter of 1998 compared
to  approximately  $1.2 million in the first  quarter of 1997.  The  significant
increase  in  three-part   management  fee  revenues  was  attributable  to  new
management  agreements  entered into in the first quarter of 1998 and the second
and the third  quarters of 1997,  and to the change in the Boston  Network  Site
management agreement pursuant to which the Company's compensation was revised to
consist of a three-part  management fee as opposed to patient service  revenues.
Management  fees based on a  percentage  of  revenues  and  reimbursed  costs of
services were  approximately  $1.0 million in the first quarter of 1998 compared
to  approximately  $879,000 in the first  quarter of 1997, an increase of 14.0%,
due to an  increase  in  volume.  Management  fees  based  on a fixed  fee  plus
reimbursed costs of services were approximately $791,000 in the first quarter of
1998  compared to $0 in the first  quarter of 1997 due to the change in the Long
Island  Network  Site  management  agreement  pursuant  to which  the  Company's
compensation  was  revised to consist  of a fixed fee plus  reimbursed  costs of
services  as opposed to  patient  service  revenues.  Patient  service  revenues
decreased to  approximately  $242,000 in the first  quarter of 1998  compared to
approximately  $2.0 million for the first  quarter of 1997 due to the changes in
the terms of the Company's management  agreements related to the Long Island and
Boston Network Sites.  AWM Division  revenues for the first quarter of 1998 were
approximately  $406,000 as compared to $668,000 for the first quarter of 1997, a
decrease of 39.2%, due to lower volume.

     Operating  expenses  incurred on behalf of the Network Sites nearly doubled
to  approximately  $7.0  million  in the first  quarter of 1998 as  compared  to
approximately  $3.6  million in the first  quarter of 1997.  This  increase  was
primarily  attributable to new management  agreements  entered into in the first
quarter  of 1998 and the  second  and the third  quarters  of 1997 under the RSC
Division.  This  increase  was also  partly  attributable  to  additional  costs
associated  with increases in volume at existing  Network Sites. As a percentage
of Revenues,  net, operating expenses increased to 80.1% in the first quarter of
1998 as compared  to 77.0% in the first  quarter of 1997,  primarily  due to the
decrease in revenues  from the AWM  Division  and to the higher cost  structures
currently  existing at the  Network  Sites  established  in the second and third
quarters of 1997 and the first quarter of 1998.

     Network Sites'  contribution  was  approximately  $1.7 million in the first
quarter of 1998 as compared  to $1.1  million in the first  quarter of 1997,  an
increase  of  approximately  61.3%,  as a result  of new  management  agreements
entered into in the first quarter of 1998 and the second and the third  quarters
of 1997 and to the  increases  in  revenues  at  existing  Network  Sites.  As a
percentage of revenues,  Network Sites'  contribution  decreased to 19.9% in the
first quarter of 1998 as compared to 23.0% in the first quarter of 1997,  due to
the negative  contribution  to earnings from  operations at the AWM Division and
the higher cost structures  currently  existing at the Network Sites established
in the second and third quarters of 1997 and the first quarter of 1998.

     General  and  administrative  expenses  for the first  quarter of 1998 were
approximately $1.2 million as compared to approximately  $977,000 million in the
first  quarter of 1997,  an  increase of 21.3%.  As a  percentage  of  revenues,
general  and  administrative  expenses  decreased  to  approximately  13.5% from
approximately 21.0% due to the increase in revenues discussed above.

     Amortization of intangible assets was $233,000 in the first quarter of 1998
as  compared  to  $137,000  in the first  quarter  of 1997.  This  increase  was
attributable to the Company's  acquisitions in the first quarter of 1998 and the
second and third quarters of 1997.

     Interest  income for the first  quarter of 1998  decreased  to $12,000 from
$34,000 for the first  quarter of 1997,  due to a lower cash  balance.  Interest
expense for the first  quarter of 1998  increased to $72,000 from $10,000 in the
first quarter of 1997, primarily due to an increase in bank borrowings.

     The provision  for income taxes  primarily  reflected  various state income
taxes  in the  first  quarter  of  1998  and  in  the  first  quarter  of  1997,
respectively.

     Net income was  $210,000 in the first  quarter of 1998 as compared to a net
loss of $45,000 in the first quarter of 1997.  This net income was primarily due
to a $660,000  increase  in Network  Site  contribution,  partially  offset by a
$208,000 increase in general and administrative  expenses, a $96,000 increase in
amortization  of  intangible  assets  and a  $84,000  increase  in net  interest
expenses.

                                      16

<PAGE>


Liquidity and Capital Resources

     Historically,  the Company has financed its  operations  primarily  through
sales of equity securities.  More recently, the Company has commenced using bank
financing for working capital and acquisition purposes.  The Company anticipates
that its  acquisition  strategy  will  continue to require  substantial  capital
investment. Capital is needed not only for additional acquisitions, but also for
the effective  integration,  operation  and expansion of the Company's  existing
Network  Sites.  The Medical  Practices may require  capital for  renovation and
expansion and for the addition of medical equipment and technology.  The Company
is in the process of seeking to obtain a line of credit to fund its  acquisition
strategy over the next year.

     During the first quarter of 1998, the Company consummated an equity private
placement of $5.5 million with entities  affiliated  with Morgan Stanley Venture
Partners  providing for the purchase of 3,235,294 shares of the Company's Common
Stock at a price of $1.70 per share and 240,000  warrants to purchase  shares of
the Company's Common Stock, at a nominal exercise price.  Approximately  half of
these funds were or will be used by the Company to purchase the capital stock of
Shady Grove and the right to manage the Shady Grove P.C.'s  infertility  medical
practice.  The balance of these funds have been and will continue to be used for
working capital purposes.

     At March 31, 1998, the Company had working  capital of  approximately  $7.1
million,  approximately  $2.4  million  of  which  consisted  of cash  and  cash
equivalents,  compared  to working  capital  of  approximately  $4.1  million at
December 31,  1997,  approximately  $1.9 million of which  consisted of cash and
cash  equivalents.  The net  increase  in working  capital at March 31, 1998 was
principally  due to the $5.5 million  proceeds  received from the equity private
placement  with Morgan  Stanley,  an  approximate  $2.4 million  increase in net
patient  accounts  receivable,  and an  approximate  $1.4  million  decrease  in
accounts payable, partially offset by approximately $3.1 million in payments for
exclusive  management rights, an approximate $1.8 million increase in short-term
debt related to the Shady Grove transaction, an approximate $455,000 increase in
Due to Medical  Providers,  and  payments of $438,000  for the purchase of fixed
assets and leasehold improvements related to new and existing Network Sites.

     During  the  first  quarter  of 1998,  the  Company  completed  its  second
in-market  merger with the  addition of two  physicians  to the FCI practice and
entered  into one new  management  agreement  with the  Shady  Grove,  P.C.  The
aggregate purchase price of these transactions,  exclusive of acquisition costs,
was  approximately  $7.2 million,  consisting of  approximately  $4.0 million in
cash, $1.5 million in promissory  notes,  823,865 shares of the Company's Common
Stock,  and  approximately  an  additional  $200,000 in shares of the  Company's
Common  Stock.  A portion of the aggregate  purchase  price related to the Shady
Grove acquisition will be paid in November 1998 as follows:  approximately  $1.0
million in cash,  $403,000 in  promissory  notes and  approximately  $200,000 in
shares of the  Company's  Common  Stock.  The $1.1 million of  promissory  notes
currently outstanding are payable in two equal annual installments, due on April
1, 1999 and 2000, respectively, and bear interest at an annual rate of 8.5%. The
number of shares of Common  Stock of the Company to be issued in  November  1998
will be determined  based upon the average closing price of the Company's Common
Stock for the ten-day  trading period prior to the third business day before the
Second  Closing  Date,  provided,  however,  that in no event will the price per
share exceed $2.00 or be less than $1.70 for purposes of this calculation.

     As of March 31, 1998, under three of its management agreements, the Company
is  obligated  to advance  funds to the Medical  Practices  to provide a minimum
physician  draw (up to an  aggregate of  approximately  $465,000 in 1998) and to
provide new services, utilize new technologies,  fund projects, purchase the net
accounts  receivable  of the  Medical  Practices  and for  other  purposes.  Any
advances are to be repaid  monthly and will bear interest at the prime rate used
by the Company's primary bank in effect at the time of the advance.

     As of March 31,  1998,  the entire  balance of the  Company's  $1.5 million
credit facility dated November 21, 1996 (the "Credit Facility") with First Union
National Bank (the "Bank") was outstanding. Borrowings under the Credit Facility
bear interest at the Bank's prime rate plus 0.75% per annum. The Credit Facility
terminates on July 1, 1998 and is secured by the Company's assets.

     On November 13, 1997, the Company entered into a $4.0 million non-restoring
line of credit with the Bank (the "New Credit  Facility").  Borrowings under the

                                       17

<PAGE>



New Credit  Facility  bear  interest at the Bank's prime rate plus 1% per annum.
Accrued interest only on borrowings is payable  commencing  December 1, 1997 and
all principal and accrued interest is due and payable on April 30, 1999. The New
Credit  Facility is cross  collateralized  and cross-  defaulted with the Credit
Facility and is secured by the Company's assets. As of March 31, 1998,  $750,000
was outstanding under the New Credit Facility.

     As of March  31,  1998,  dividend  payments  of  $497,000  on the  Series A
Cumulative  Convertible Preferred Stock (the "Convertible Preferred Stock") were
in arrears.  The Company does not anticipate the payment of any dividends on the
Convertible Preferred Stock in the foreseeable future.

Fluctuations in Quarterly Results

     The Company's  revenues are typically lower during the first quarter of the
Company's fiscal year. This lower level of revenues is primarily attributable to
the commencement of fertility treatment by the patients of the Medical Practices
at the beginning of the calendar year.  Quarterly results also may be materially
affected by the timing of  acquisitions  and the timing and  magnitude  of costs
related to acquisitions.  Therefore, results for any quarter are not necessarily
indicative of the results that the Company may achieve for any subsequent fiscal
quarter or for a full fiscal year.

Forward Looking Statements

     This Form 10-Q and discussions and/or announcements made by or on behalf of
the Company,  contain certain  forward-looking  statements within the meaning of
the "safe harbor" provisions of the Private Securities  Litigation Reform Act of
1995,  the  attainment  of  which  involve  various  risks  and   uncertainties.
Forward-looking  statements  may be  identified  by the  use of  forward-looking
terminology   such  as,  "may,"   "will,"   "expect,"   "believe,"   "estimate,"
"anticipate,"  "continue,"  or similar  terms,  variations of those terms or the
negative of those terms. The Company's actual results may differ materially from
those  described  in  these  forward-looking  statements  due to  the  following
factors:  the Company's  ability to acquire  additional  management  agreements,
including  the  Company's  ability  to  finance  future  growth,   the  loss  of
significant  management  agreement(s),  the  profitability  or lack  thereof  at
Network Sites managed by the Company,  the Company's  ability to transition sole
practitioners to group practices, the development of the AWM Division, increases
in overhead  due to  expansion,  the  exclusion  of  infertility,  ART and other
women's  reproductive  healthcare services from insurance  coverage,  government
laws and regulation  regarding health care, changes in managed care contracting,
and the timely  development of and acceptance of new  infertility,  ART, genetic
and/or women's healthcare technologies and techniques.

Item 3.  Quantitative and Qualitative Disclosures About Market Risk

     Not applicable.

                                       18

<PAGE>

Part II -         OTHER INFORMATION

     Item 1.      Legal Proceedings.
                        Not applicable.

     Item 2.      Changes in Securities.
                        The following sets forth all of the  unregistered  sales
                        of securities by the Company during the first quarter of
                        1998:

                        i.   In January 1998, the Company amended its management
                             agreement  with  FCI to  include  two of the  three
                             physicians  practicing under CFRM (See Note 6). The
                             aggregate  consideration  included  the issuance of
                             184,314   shares  of   Common   Stock  to  the  two
                             physicians who became affiliated with FCI.

                        ii.  In January 1998, the Company  consummated an equity
                             private  placement of $5.5  million  with  entities
                             (the  "Funds")   affiliated   with  Morgan  Stanley
                             Venture  Partners  providing for the purchase of 3,
                             235,294  shares of the Company's  Common Stock at a
                             price of $1.70 per share and  240,000  warrants  to
                             purchase shares of the Company's Common Stock, at a
                             nominal exercise price.

                        iii. In March  1998,  the  Company  issued  warrants  to
                             acquire   60,000  shares  of  Common  Stock  at  an
                             exercise   price   of  $1.80   per   share  to  the
                             shareholders of FCI in  consideration  of extending
                             the Company's management agreement with FCI from 20
                             to 25 years.

                        iv.  In  March  1998,   the  Company   consummated   the
                             acquisition  of a majority of the capital  stock of
                             Shady  Grove  Fertility  Centers,  Inc.  As partial
                             payment of the  consideration for the capital stock
                             acquired,  the  Company  issued  639,551  shares of
                             Common Stock.

                        The above  transactions  were private  transactions  not
                        involving  a public  offering  and were  exempt from the
                        registration  provisions of the  Securities Act of 1933,
                        as amended,  pursuant to Section 4(2) thereof. Except as
                        otherwise indicated,  the sale of securities was without
                        the  use  of  an  underwriter,   and  the   certificates
                        evidencing   the  shares  bear  a   restrictive   legend
                        permitting the transfer  thereof only upon  registration
                        of the shares or an exemption  under the  Securities Act
                        of 1933, as amended.

     Item 3.      Defaults Upon Senior Securities.
                        As of March 31, 1998,  dividend  payments of $497,000 on
                        the Convertible Preferred Stock were in arrears.

     Item 4.      Submission of Matters to Vote of Security Holders.
                        None.

     Item 5.      Other Information.
                        In  connection  with the  Company's  January 1998 equity
                        private  placement  with the Funds,  M. Fazle Husain,  a
                        managing  member  of a  general  partner  of the  Funds,
                        became  a member  of the  Company's  Board of  Directors
                        effective January 23, 1998.

                        Pursuant  to the  Company's  management  agreement  with
                        Shady Grove Fertility  Centers,  Inc.,  Michael J. Levy,
                        M.D.,   an  employed   shareholder   physician   of  the
                        affiliated  medical  practice,  became a  member  of the
                        Company's Board of Directors effective March 12, 1998.

     Item 6.      Exhibits and Reports on Form 8-K.

                     (a) Exhibits.
                             See Index to Exhibits on pages 21-22.
                     (b) Reports on Form 8-K.
                             On March  24,  1998,  the  Company  filed  with the
                             Securities  and  Exchange  Commission  a  Form  8-K
                             reporting the Company's acquisition of the majority
                             of the  capital  stock  of  Shady  Grove  Fertility
                             Centers, Inc.

                                       19

<PAGE>








                                   SIGNATURES


         Pursuant to the  requirements  of the Securities  Exchange Act of 1934,
the  Registrant  has duly  caused  this report to be signed on its behalf by the
undersigned thereunto duly authorized.


                                                  INTEGRAMED AMERICA, INC.
                                                  (Registrant)




Date: May 14, 1998                       By:      /s/ Eugene R. Curcio
                                                  --------------------
                                                  Eugene R. Curcio
                                                  Vice President and
                                                  Chief Financial Officer
                                                  (Principal Financial and
                                                  Accounting Officer)


                                                      20

<PAGE>




                                INDEX TO EXHIBITS


Exhibit
Number                                                  Exhibit

4.9 (a) --   Warrant issued to Brian Kaplan, M.D.

4.9 (b) --   Warrant issued to Aaron S. Lifchez, M.D.

4.9 (c) --   Warrant issued to Jacob Moise, M.D.

4.9 (d) --   Warrant issued to Jorge Valle, M.D.

4.10(a) --   Warrant issued to Donald Galen, M.D.

4.10(b) --   Warrant issued to Arnold Jacobson, M.D.

4.10(c) --   Warrant issued to Louis Weckstein, M.D.

4.11(a) --   Warrant issued to Michael J. Levy, M.D.

4.11(b) --   Warrant issued to Arthur W. Sagoskin, M.D.

4.11 (c)--   Warrant issued to Robert J. Stillman, M.D.

10.2 (a)--   Copy of Amendment to Registrant's 1992 Stock Option Plan (4)

10.61(a)--   Amendment No. 1 to Management Agreement between IntegraMed America,
             Inc. and Bay Area Fertility and Gynecology Medical Group, Inc.

10.80(a) --  Amendment   effective   January  29,   1998  to   Contract   Number
             DADA15-96-C-009 between INMD and the Department of the Army, Walter
             Reed Army  Medical  Center  for In Vitro  Fertilization  Laboratory
             Services.

10.93    --  Amendment  No. 4 to Management  Agreement  between  Registrant  and
             Fertility Centers of Illinois, S.C. dated January 9, 1998 (1)

10.94    --  Investment  Agreement between Registrant and Morgan Stanley Venture
             Partners III, L.P.., Morgan Stanley Venture Investors III, L.P. and
             the Morgan Stanley Venture Partners Entrepreneur Fund, L.P. (2)

10.95    --  Amendment  No. 5 to Management  Agreement  between  Registrant  and
             Fertility Centers of Illinois, S.C. dated March 5, 1998 (3).

10.96    --  Termination  Agreement  by and among  Women's  Medical & Diagnostic
             Center,  Inc., W. Banks  Hinshaw,  Jr.,  Ph.D.,  M.D., and Robin E.
             Markle, M.D. (3)

10.100   --  Asset Purchase and Sale Agreement by and among IntegraMed  America,
             Inc. and  Fertility  Centers of Illinois,  S.C.,  Advocate  Medical
             Group, S.C. and Advocate MSO, Inc. dated January 9, 1998 (3)

10.101   --  Physician   Employment   Agreement  between  Fertility  Centers  of
             Illinois,  S.C. and Laurence A. Jacobs,  M.D. dated January 9, 1998
             (3).

10.102   --  Physician   Employment   Agreement  between  Fertility  Centers  of
             Illinois,  S.C. and John J.  Rapisarda,  M.D. dated January 9, 1998
             (3).

                                       21

<PAGE>



10.103   --  Personal  Responsibility   Agreement  entered  into  by  and  among
             IntegraMed America,  Inc., Fertility Centers of Illinois,  S.C. and
             John J. Rapisarda, M.D. dated January 9, 1998 (3).

10.104   --  Personal  Responsibility   Agreement  entered  into  by  and  among
             IntegraMed America,  Inc., Fertility Centers of Illinois,  S.C. and
             Laurence A. Jacobs, M.D. dated January 9, 1998 (3).

10.105   --  Management  Agreement between Shady Grove Fertility  Centers,  P.C.
             and Levy,  Sagoskin and Stillman,  M.D.,  P.C. dated March 11, 1998
             (3).

10.105(a) -- Amendment  No.  1  to  Management  Agreement  between  Shady  Grove
             Fertility Centers, Inc. and Levy, Sagoskin and Stillman, M.D.,P.C.

10.106   --  Submanagement Agreement between Shady Grove Fertility Centers, Inc.
             and IntegraMed America, Inc. dated March 12, 1998 (3).

10.107   --  Stock Purchase and Sale Agreement among  Integramed  America,  Inc.
             and Michael J. Levy, M.D.,  Robert J. Stillman,  M.D. and Arthur W.
             Sagoskin, M.D. dated March 12, 1998 (3).

10.108   --  Personal Responsibility  Agreement by and among IntegraMed America,
             Inc. and Arthur W. Sagoskin, M.D. dated March 12, 1998 (3).

10.109   --  Personal Responsibility  Agreement by and among IntegraMed America,
             Inc. and Michael J. Levy, M.D. dated March 12, 1998 (3).

10.110   --  Physician-Stockholder  Employment  Agreement between Levy, Sagoskin
             and Stillman,  M.D., P.C. and Michael J. Levy, M.D. dated March 11,
             1998 (3).

10.111   --  Physician-Stockholder  Employment  Agreement between Levy, Sagoskin
             and Stillman,  M.D., P.C. and Arthur W. Sagoskin,  M.D. dated March
             11, 1998 (3).

10.112   --  Physician-Stockholder  Employment  Agreement between Levy, Sagoskin
             and Stillman,  M.D., P.C. and Robert J. Stillman,  M.D. dated March
             11, 1998 (3).

27       --  Financial Data Schedule

- ----------------------------------------

(1)  Filed as  Exhibit  with  identical  exhibit  number to  Schedule  13D dated
     February 11, 1998.

(2)  Filed as Exhibit with identical  exhibit number to  registrant's  Report on
     Form 8-K dated January 23, 1998.

(3)  Incorporated  by  reference  to the Exhibit  with the  identical  number to
     Registrant's  Annual  Report on Form 10-K for the year ended  December  31,
     1997.

(4)  Incorporated by reference to the  Registrant's  Definitive  Proxy Statement
     filed on May 5, 1998.

                                       22


              VOID AFTER 5:00 P.M. NEW YORK TIME, ON MARCH 5, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE RECEIVED,  BRIAN KAPLAN, or
assigns ("Holder"),  is entitled to purchase,  subject to the provisions of this
Warrant,  from IntegraMed  America,  Inc., a Delaware  corporation  ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.80 per
share at any time or from time to time  during the period  from March 6, 1998 to
March 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on March 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  March 6,  1998 and until  March 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the



                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

     
                                        3

<PAGE>



                 

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


 
                                        4

<PAGE>
including a statementof the number of additional shares of Common Stock, if any,
and such other facts as shall be necessary to show the reason for and the manner
of computing  such  adjustment.  Each such officer's  certificate  shall be made
available at all reasonable  times for inspection by the holder or any holder of
a Warrant executed and delivered  pursuant to Section (a) and the Company shall,
forthwith  after each such  adjustment,  mail a copy by  certified  mail of such
certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                  INTEGRAMED AMERICA, INC.

                                   By: /s/Gerardo Canet
                                       ------------------------------
                                       Gerardo Canet, President & CEO

Dated:  ____________, 1998


Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]




 
                                        5


<PAGE>




                                  PURCHASE FORM


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________



<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


              VOID AFTER 5:00 P.M. NEW YORK TIME, ON MARCH 5, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE RECEIVED, AARON S. LIFCHEZ,
or assigns  ("Holder"),  is entitled to purchase,  subject to the  provisions of
this Warrant, from IntegraMed America, Inc., a Delaware corporation ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.80 per
share at any time or from time to time  during the period  from March 6, 1998 to
March 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on March 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  March 6,  1998 and until  March 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the



                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

     
                                        3

<PAGE>



                 

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


 
                                        4

<PAGE>

including a statementof the number of additional shares of Common Stock, if any,
and such other facts as shall be necessary to show the reason for and the manner
of computing  such  adjustment.  Each such officer's  certificate  shall be made
available at all reasonable  times for inspection by the holder or any holder of
a Warrant executed and delivered  pursuant to Section (a) and the Company shall,
forthwith  after each such  adjustment,  mail a copy by  certified  mail of such
certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                  INTEGRAMED AMERICA, INC.


                                   By: /s/Gerardo Canet
                                       ------------------------------
                                       Gerardo Canet, President & CEO

Dated:  ____________, 1998




Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]


                                        5


<PAGE>




                                  PURCHASE FORM


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________



<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


              VOID AFTER 5:00 P.M. NEW YORK TIME, ON MARCH 5, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE  RECEIVED,  JACOB MOISE, or
assigns ("Holder"),  is entitled to purchase,  subject to the provisions of this
Warrant,  from IntegraMed  America,  Inc., a Delaware  corporation  ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.80 per
share at any time or from time to time  during the period  from March 6, 1998 to
March 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on March 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  March 6,  1998 and until  March 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the



                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

     
                                        3

<PAGE>



                 

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


 
                                        4

<PAGE>

including a statementof the number of additional shares of Common Stock, if any,
and such other facts as shall be necessary to show the reason for and the manner
of computing  such  adjustment.  Each such officer's  certificate  shall be made
available at all reasonable  times for inspection by the holder or any holder of
a Warrant executed and delivered  pursuant to Section (a) and the Company shall,
forthwith  after each such  adjustment,  mail a copy by  certified  mail of such
certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                  INTEGRAMED AMERICA, INC.


                                   By: /s/Gerardo Canet
                                       ------------------------------
                                       Gerardo Canet, President & CEO

Dated:  ____________, 1998



Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]


                                        5


<PAGE>




                                  PURCHASE FORM


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________



<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


              VOID AFTER 5:00 P.M. NEW YORK TIME, ON MARCH 5, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE  RECEIVED,  JORGE VALLE, or
assigns ("Holder"),  is entitled to purchase,  subject to the provisions of this
Warrant,  from IntegraMed  America,  Inc., a Delaware  corporation  ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.80 per
share at any time or from time to time  during the period  from March 6, 1998 to
March 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on March 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  March 6,  1998 and until  March 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the



                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

     
                                        3

<PAGE>



                 

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


 
                                        4

<PAGE>

including a statementof the number of additional shares of Common Stock, if any,
and such other facts as shall be necessary to show the reason for and the manner
of computing  such  adjustment.  Each such officer's  certificate  shall be made
available at all reasonable  times for inspection by the holder or any holder of
a Warrant executed and delivered  pursuant to Section (a) and the Company shall,
forthwith  after each such  adjustment,  mail a copy by  certified  mail of such
certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                  INTEGRAMED AMERICA, INC.


                                   By: /s/Gerardo Canet
                                       ------------------------------
                                       Gerardo Canet, President & CEO

Dated:  ____________, 1998



Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]

                                        5


<PAGE>




                                  PURCHASE FORM


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________



<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


               VOID AFTER 5:00 P.M. NEW YORK TIME, ON ARIL 6, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE RECEIVED,  DONALD GALEN, or
assigns ("Holder"),  is entitled to purchase,  subject to the provisions of this
Warrant,  from IntegraMed  America,  Inc., a Delaware  corporation  ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.75 per
share at any time or from time to time  during the period  from April 6, 1998 to
April 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on April 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  April 6,  1998 and until  April 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the


            
                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of


 
                                        2

<PAGE>


this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

                                        3

<PAGE>

               

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g)   OFFICER'S CERTIFICATE. Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,
including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the
Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

 
                                        4

<PAGE>


                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.



                                           INTEGRAMED AMERICA, INC.



                                         By: /s/Gerardo Canet
                                             ------------------------------
                                             Gerardo Canet, President & CEO

Dated: April 6, 1998


Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]


                                        5

<PAGE>



                                  PURCHASE FORM
                                  -------------


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK
                     --------------------------------------



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM


                  FOR VALUE RECEIVED,  ______________  hereby sells, assigns and
transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________






    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************



               VOID AFTER 5:00 P.M. NEW YORK TIME, ON ARIL 6, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE RECEIVED,  ARNOLD JACOBSON,
or assigns  ("Holder"),  is entitled to purchase,  subject to the  provisions of
this Warrant, from IntegraMed America, Inc., a Delaware corporation ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.75 per
share at any time or from time to time  during the period  from April 6, 1998 to
April 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on April 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  April 6,  1998 and until  April 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the


            
                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of


 
                                        2

<PAGE>


this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

                                        3

<PAGE>

               

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g)   OFFICER'S CERTIFICATE. Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,
including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the
Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

 
                                        4

<PAGE>





                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.



                                           INTEGRAMED AMERICA, INC.



                                         By: /s/Gerardo Canet
                                             ------------------------------   
                                             Gerardo Canet, President & CEO

Dated: April 6, 1998


Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]





                                        5

<PAGE>



                                  PURCHASE FORM
                                  -------------


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK
                     --------------------------------------



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM


                  FOR VALUE RECEIVED,  ______________  hereby sells, assigns and
transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________






    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************



               VOID AFTER 5:00 P.M. NEW YORK TIME, ON ARIL 6, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE RECEIVED,  LOUIS WECKSTEIN,
or assigns  ("Holder"),  is entitled to purchase,  subject to the  provisions of
this Warrant, from IntegraMed America, Inc., a Delaware corporation ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.75 per
share at any time or from time to time  during the period  from April 6, 1998 to
April 5,  2003,  but not later than 5:00 p.m.  New York City  Time,  on April 5,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  April 6,  1998 and until  April 5,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the


            
                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of


 
                                        2

<PAGE>


this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

                                        3

<PAGE>

               

                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g)   OFFICER'S CERTIFICATE. Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,
including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the
Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

 
                                        4

<PAGE>





                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.



                                           INTEGRAMED AMERICA, INC.



                                         By: /s/Gerardo Canet
                                             ------------------------------   
                                             Gerardo Canet, President & CEO

Dated: April 6, 1998


Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]





                                        5

<PAGE>



                                  PURCHASE FORM
                                  -------------


                                                 Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the

within  Warrant to the extent of purchasing  _______  shares of Common Stock and

hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK
                     --------------------------------------



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________





<PAGE>



                                 ASSIGNMENT FORM


                  FOR VALUE RECEIVED,  ______________  hereby sells, assigns and
transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________






    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************



              VOID AFTER 5:00 P.M. NEW YORK TIME, ON ARIL 15, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE  RECEIVED,MICHAEL  J. LEVY,
or assigns  ("Holder"),  is entitled to purchase,  subject to the  provisions of
this Warrant, from IntegraMed America, Inc., a Delaware corporation ("Company"),
15,000 fully paid, validly issued and nonassessable  shares of Common Stock, par
value $.01 per share,  of the Company  ("Common  Stock") at a price of $1.75 per
share at any time or from time to time  during the period from April 16, 1998 to
April 15, 2003,  but not later than 5:00 p.m.  New York City Time,  on April 15,
2003.  The number of shares of Common Stock to be received  upon the exercise of
this  Warrant  and the price to be paid for each  share of  Common  Stock may be
adjusted from time to time as hereinafter set forth.  The shares of Common Stock
deliverable  upon  such  exercise,  and as  adjusted  from  time  to  time,  are
hereinafter  sometimes referred to as "Warrant Shares" and the exercise price of
a share of Common Stock in effect at any time and as adjusted  from time to time
is hereinafter sometimes referred to as the "Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  April 16, 1998 and until April 15,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the


  
                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

   
                                        3

<PAGE>



                  
                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


  
                                        4

<PAGE>

including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the
Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                            INTEGRAMED AMERICA, INC.


                                            By: /s/Gerardo Canet
                                               ------------------------------ 
                                               Gerardo Canet, President & CEO

Dated: April 16, 1998



Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]




                                        5


<PAGE>




                                  PURCHASE FORM


                                                Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the


within  Warrant to the extent of purchasing  _______  shares of Common Stock and
hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________




  
<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________


 
<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


              VOID AFTER 5:00 P.M. NEW YORK TIME, ON ARIL 15, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This  is  to  Certify  That,  FOR  VALUE   RECEIVED,ARTHUR  W.
SAGOSKIN,  or  assigns  ("Holder"),  is  entitled  to  purchase,  subject to the
provisions  of  this  Warrant,   from  IntegraMed  America,   Inc.,  a  Delaware
corporation  ("Company"),  15,000 fully paid,  validly issued and  nonassessable
shares of Common  Stock,  par value  $.01 per  share,  of the  Company  ("Common
Stock")  at a price of $1.75 per  share at any time or from time to time  during
the period from April 16, 1998 to April 15,  2003,  but not later than 5:00 p.m.
New York City Time,  on April 15, 2003.  The number of shares of Common Stock to
be received  upon the exercise of this Warrant and the price to be paid for each
share of Common  Stock may be  adjusted  from  time to time as  hereinafter  set
forth.  The  shares of Common  Stock  deliverable  upon  such  exercise,  and as
adjusted from time to time, are  hereinafter  sometimes  referred to as "Warrant
Shares" and the exercise  price of a share of Common Stock in effect at any time
and as adjusted from time to time is  hereinafter  sometimes  referred to as the
"Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  April 16, 1998 and until April 15,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the


  
                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

   
                                        3

<PAGE>



                  
                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


  
                                        4

<PAGE>

including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the
Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                            INTEGRAMED AMERICA, INC.



                                            By: /s/Gerardo Canet
                                               ------------------------------ 
                                               Gerardo Canet, President & CEO

Dated: April 16, 1998



Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary

[Seal]


                                        5


<PAGE>




                                  PURCHASE FORM


                                                Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the


within  Warrant to the extent of purchasing  _______  shares of Common Stock and
hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________




  
<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________


 
<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


              VOID AFTER 5:00 P.M. NEW YORK TIME, ON ARIL 15, 2003
                WARRANT TO PURCHASE 15,000 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This  is to  Certify  That,  FOR  VALUE  RECEIVED,  ROBERT  J.
STILLMAN,  or  assigns  ("Holder"),  is  entitled  to  purchase,  subject to the
provisions  of  this  Warrant,   from  IntegraMed  America,   Inc.,  a  Delaware
corporation  ("Company"),  15,000 fully paid,  validly issued and  nonassessable
shares of Common  Stock,  par value  $.01 per  share,  of the  Company  ("Common
Stock")  at a price of $1.75 per  share at any time or from time to time  during
the period from April 16, 1998 to April 15,  2003,  but not later than 5:00 p.m.
New York City Time,  on April 15, 2003.  The number of shares of Common Stock to
be received  upon the exercise of this Warrant and the price to be paid for each
share of Common  Stock may be  adjusted  from  time to time as  hereinafter  set
forth.  The  shares of Common  Stock  deliverable  upon  such  exercise,  and as
adjusted from time to time, are  hereinafter  sometimes  referred to as "Warrant
Shares" and the exercise  price of a share of Common Stock in effect at any time
and as adjusted from time to time is  hereinafter  sometimes  referred to as the
"Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be exercised in whole or in part
at any time or from time to time on or after  April 16, 1998 and until April 15,
2003 (the  "Exercise  Period"),  subject to the  provisions  of  Section  (j)(2)
hereof;  provided,  however,  that  if  such  day  is a  day  on  which  banking
institutions  in the State of New York are  authorized by law to close,  then on
the next  succeeding  day which  shall not be such a day.  This  Warrant  may be
exercised by presentation  and surrender  hereof to the Company at its principal
office,  or at the office of its stock transfer agent, if any, with the Purchase
Form annexed  hereto duly  executed and  accompanied  by payment of the Exercise
Price for the  number of  Warrant  Shares  specified  in such  form.  As soon as
practicable  after each such exercise of the warrants,  but not later than seven
(7) days from the date of such exercise,  the Company shall issue and deliver to
the Holder a certificate  or certificate  for the Warrant  Shares  issuable upon
such  exercise,  registered in the name of the Holder or its  designee.  If this
Warrant should be exercised in part only,  the Company shall,  upon surrender of
this Warrant for cancellation,  execute and deliver a new Warrant evidencing the


  
                                        1

<PAGE>



rights of the Holder  thereof to  purchase  the  balance of the  Warrant  Shares
purchasable  thereunder.  Upon  receipt by the  Company  of this  Warrant at its
office,  or by the stock transfer agent of the Company at its office,  in proper
form for exercise,  the Holder shall be deemed to be the holder of record of the
shares of Common Stock  issuable upon such  exercise,  notwithstanding  that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling
the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common Stock purchasable hereunder. This Warrant is not transferable (other than
by will or pursuant to the laws of descent and distribution).  Upon surrender of



                                        2

<PAGE>



this  Warrant  to the  Company at its  principal  office or at the office of its
stock  transfer  agent,  if any, with the  Assignment  Form annexed  hereto duly
executed  and funds  sufficient  to pay any  transfer  tax,  the Company  shall,
without  charge,  execute and deliver a new Warrant in the name of the  assignee
named in such  instrument  of  assignment  and this  Warrant  shall  promptly be
canceled.  This  Warrant may be divided or combined  with other  warrants  which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.

   
                                        3

<PAGE>



                  
                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,


  
                                        4

<PAGE>

including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the
Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.


                                            INTEGRAMED AMERICA, INC.


                                            By: /s/Gerardo Canet
                                               ------------------------------ 
                                               Gerardo Canet, President & CEO

Dated: April 16, 1998



Attest:


- -----------------------------
Claude E. White, Secretary

[Seal]


                                        5


<PAGE>




                                  PURCHASE FORM


                                                Date: ________________________

                  The  undersigned  hereby  irrevocably  elects to exercise  the


within  Warrant to the extent of purchasing  _______  shares of Common Stock and
hereby makes payment of _______ in payment of the actual exercise price thereof.

                                ----------------



                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________




  
<PAGE>



                                 ASSIGNMENT FORM

     FOR VALUE RECEIVED, ______________ hereby sells, assigns and transfers unto


Name _____________________________
(Please typewrite or print in block letters)


Address ____________________________

the right to purchase Common Stock  represented by this Warrant to the extent of
______ shares as to which such right is exercisable and does hereby  irrevocably
constitute  and appoint  ___________  as  attorney,  to transfer the same on the
books of the Company with full power of substitution in the premises.

Date:_____________________________


Signature _________________________


 
<PAGE>



    ************************************************************************













                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















    ************************************************************************


                     AMENDMENT NO. 1 TO MANAGEMENT AGREEMENT

                                     BETWEEN

                            INTEGRAMED AMERICA, INC.

                                       AND

              BAY AREA FERTILITY AND GYNECOLOGY MEDICAL GROUP, INC.


         THIS  AMENDMENT NO. 1 TO MANAGEMENT  AGREEMENT ( "Amendment  No. 1") is
dated  April 5, 1998 by and  between  IntegraMed  America,  Inc.,  a  Delaware
corporation,  with its principal place of business at One  Manhattanville  Road,
Purchase,  New York 10577 ("INMD") and Bay Area Fertility and Gynecology Medical
Group Inc., a California  professional medical  corporation,  with its principal
place of business at 3160 Crow Canyon  Road,  Suite 150,  San Ramon,  California
94583 ("Bay Area Fertility").

                                    RECITALS:

         WHEREAS,  INMD  and  Bay  Area  Fertility  entered  into  a  Management
Agreement  dated  January  7,  1997  (the  "Management  Agreement")which  became
effective as of January 8, 1997 ("Effective Date"); and

         WHEREAS,  INMD is willing to grant to each of Donald Galen,  MD, Arnold
Jacobson,  MD and Louis  Weckstein,  MD, the  stockholders of Bay Area Fertility
("Stockholders"),  warrants  to acquire  15,000  shares,  respectively,  of INMD
Common  Stock (the  "Warrants")  at a price equal to the  closing  price of INMD
Common Stock on the date of this  Agreement,  and with an expiration date of the
Warrants that is five (5) years from issuance.; provided, the Stockholders cause
Bay Area  Fertility to amend the  Management  Agreement so as to extend the term
from 20 years to 25 years; and

         WHEREAS,  Bay Area  Fertility,  based on approval of  Stockholders,  is
willing to extend the  Management  Agreement  for five (5) years so as to expire
twenty-five (25) years from the Effective Date.

         NOW THEREFORE,  in  consideration  of the mutual promises and covenants
herein  contained,  and as contained in the Management  Agreement,  INMD and Bay
Area Fertility agree as follows:

         1. The first  sentence of Section 7.2 of The  Management  Agreement  is
hereby deleted and the following sentence is hereby substituted therefor:

                  "The term of this  Agreement  shall begin on the Closing  date
                  and shall expire twenty-five (25) years after such date unless
                  earlier terminated pursuant to Article 8, below."



<PAGE>


         2. All other  provisions of the Management  Agreement,  not in conflict
with this Amendment No. 1 remain in full force and effect.

         3. This  Amendment  No. 1 may be  executed  in any  number of  separate
counterparts,  each of which shall be deemed to be an original, but all of which
together shall constitute one and the same instrument.

         4. Upon  execution of this Amendment by Bay Area  Fertility,  INMD will
issue the Warrants to the Stockholders.

         IN WITNESS  WHEREOF,  the parties have signed this  Amendment No. 1 the
date first above written.


INTEGRAMED AMERICA, INC.



By:/s/Gerardo Canet
   ------------------------
   Gerardo Canet, President



BAY AREA FERTILITY AND GYNECOLOGY MEDICAL GROUP, INC.



By:/s/Arnold Jacobson
   --------------------------
   Arnold Jacobson, President



               AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

                                                               Page 1 of Page 5
     1.  CONTRACT ID CODE 

     2.  AMENDMENT/MODIFICATION NO.:  P00004

     3.  EFFECTIVE DATE:  01/29/98

     4.  REQUISITION/PURCHASE REQ. NO.:  YMEC00-5226-6911

     5.  PROJECT NO.  (if applicable)

     6.   ISSUED BY: DIR OF CONTRACTING WALTER REED AMC        CODE:    DADA15
                  ATTN  MCHL  Z  BLDG  T  20
                  6825  16TH STREET NW
                  WASHINGTON, DC  20307-5000

     7.   ADMINISTERED BY (if other than item 6): MARY L. POOL CODE:    K29
                                                 TEL:  (202)  782-1416

     8.   NAME AND ADDRESS OF CONTRACTOR
            (No., street, county, State and ZIP Code)
                           INTEGRAMED AMERICA, INC.       VENDOR ID:  00030356
                           ONE MANHATTANVILLE ROAD
                           PURCHASE, NY  105772100

(X)  9A.  AMENDMENT OF SOLICITATION NO.: 

     9B.  DATED (SEE ITEM 11):

(X)  10A. MODIFICATION OF CONTRACT/ORDER NO.: DADA15-96-C-0009 

     10B. DATED   (SEE ITEM 13):  12/06/95

- --------------------------------------------------------------------------------
CODE                                        FACILITY CODE
- --------------------------------------------------------------------------------

     11.  THIS ITEM ONLY APPLIED TO AMENDMENTS OF SOLICITATIONS

      |_|The above numbered solicitation is amended as set forth in Item 14. The
      hour and date specified for receipt of Offers |_| is extended,  |_| is not
      extended.  Offers must acknowledge  receipt of this amendment prior to the
      hour and date specified in the  solicitation or as amended,  by one of the
      following  methods:  (a) By  completing  Items  8 and  15,  and  returning
      ___copies of the amendment; (b) By acknowledging receipt of this amendment
      on each copy of the offer submitted; or (c) By separate letter or telegram
      which  includes a reference to the  solicitation  and  amendment  numbers.
      FAILURE OF YOUR  ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR
      THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE  SPECIFIED  MAY RESULT IN
      REJECTION  OF YOUR  OFFER.  If by virtue of this  amendment  you desire to
      change an offer  already  submitted,  such  change may be made by telegram
      letter,   provided  each  telegram  or  letter  makes   reference  to  the
      solicitation and this amendment, and is received prior to the opening hour
      and date specified.

     12.  ACCOUNTING AND APPROPRIATION DATA
             (if required):  Mod Obligated Amount US               $ 0.00
                        NO COST TO THE GOVERNMENT                  EFT:    T

     13.  THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
          IT MODIFIED THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

(X)  A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:(Specify authority)
        THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT
        ORDER NO. IN ITEM 10A

     B. THE  ABOVE   NUMBERED   CONTRACT/ORDER   IS  MODIFIED  TO  REFLECT  THE
        ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation
        date,  etc.) SET FORTH IN ITEM 14,  PURSUANT  TO THE  AUTHORITY  OF FAR
        43.103(b)

 (X) C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
        FAR 52.243.1

     D. OTHER   (Specify type of modification and authority)

     E. IMPORTANT: Contractor | |is not,
                              |X|is required to sign this document and return
                                 2  copies to the issuing office.
 -------------------------------------------------------------------------------



<PAGE>



DESCRIPTION  OF  AMENDMENT/MODIFICATION  (Organized  by  UCF  section  headings,
including solicitation/contract subject matter where feasible.)

  Subject  modification  is  issued  to  reflect  the  following changes:


        1.  In accordance with Section-H, Paragraph H-3, FAR 52.217-9 "Option To
            Extend The Terms Of Contract." The Government elects to exercise its
            second option of the contract.

  Except as provided herein, all terms and conditions of the document referenced
  in item 9A or 10A, as heretofore changed,  remains unchanged and in full force
  and effect.

15A. NAME AND TITLE OF SIGNER (Type or print):

     Donald S. Wood, Ph.D.
     IntegraMed America, Inc.

15B. CONTRACTOR/OFFEROR

     /s/Donald S. Wood
     ------------------------------------
     (Signature of person authorized to sign)

15C.   DATE SIGNED:      4/15/98

16A.   NAME AND TITLE OF CONTRACTING OFFICER  (Type or print):

       Roland Thomas        K63

16B.   UNITED STATES OF AMERICA

       By: /s/Roland Thomas
           --------------------------
           (Signature of Contracting Officer)

16C.   DATE SIGNED:  4/16/98

<PAGE>

                                                      SF 30 CONTINUATION SHEET

   2.   Line items #0003 thru 0003AG for the option  period 01 January 1998 thru
        December 1998.

   3.   The statement of work is revised as follows:

        C.  1.a2.  The  Contractor  must  meet a 50%  pregnancy  rate  for  ICSI
   (Intracytoplasmic  sperm injection) a clinical pregnancies with TESA and MESA
   (epidyimal sperm  aspiration),  and a >40% ongoing  delivered  pregnancy rate
   overall. A >30% pregnancy rate for (FET) frozen embryo transfer cycles.  Must
   meet  HCLA  board  certified  and  have  CLIA and CAP  certification  for the
   laboratory.  Must  have  twenty  (20) or  more  peer  reviewed  publications.
   Documentation of involvement in a fellow thesis in Reproductive Endocrinology
   and  Infertility.   Must  be  capable  of  performing  all  micromanipulation
   techniques ICSI (Intracytoplasmic  Sperm Injection) Assisted embryo hatching,
   partial zona drilling and support two research  protocols per year. Must have
   Applied to the  Society for  Assisted  Reproductive  Technologies  (SART) for
   membership and paid required fees, to support SART data collection and input.

        Changed: C. 1.a2. The pregnancy  rates refer to  pregnancies  per embryo
   transfer for women under age 39 and the rates are to be established  over the
   one-year  contract  period  for  1998.  The  Government  and  the  Contractor
   recognize that the pregnancy  rates are the result of a combined  effort that
   includes the Contractor and the Government.  In addition,  the Government and
   the  Contractor  recognize  that  the  pregnancy  rates  may be  affected  by
   situations  such as the air quality over which the Contractor has no control.
   Accordingly,  if one or more of the pregnancy  rates for a given  category of
   patient do not meet or exceed those in the  Statement  of Work,  the military
   and the  Contractor  agree to cooperate and use their best efforts to improve
   the rates to the levels agreed to. Best efforts means that the Contractor and
   the  Government  shall  mutually  agree to a  written  plan  approved  by the
   Contracting Officer for improving rates over a reasonable period of time.

       C. 1.a3. The Contractor must provide full service  cryobiology program to
   include storage of embryos and sperm all laboratory equipment and staffing as
   work load requires. Capability to move to an outside facility if the military
   is unable to provide on-site space.

       Changed:  C. 1.a3. The Contractor will use its best efforts to move to an
   outside  facility if the  Government  is unable to provide  on-site  space in
   support of a cryobiology  program.  The  Government  agrees that it will work
   cooperatively  with the  Contractor to agree that it will work  cooperatively
   with the  Contractor  to  relocate  to an  outside  space  and  will  provide
   Contractor  with at least  120  days  notice  that a move of the  cryobiology
   program to an outside space is necessary.  Cooperation  includes,  but is not
   limited  to,  providing  a secure  space in  which to store  all  cryobiology
   equipment and materials,  providing Contractor with access to patient records
   for the purpose of notifying patients that a move of the cryobiology  program
   will take place.


<PAGE>

                                                     SF  30  CONTINUATION  SHEET

       C 1.a4. The Contractor must provide a backup alarm system. All laboratory
   employees  must carry a beeper  and be able to  respond to alarm  twenty-four
   (24) hours a day 365 days per year. C. 1.a9. The Contractor  must provide two
   (2) nurse coordinators and two (2) full time administrators.

      Changed:  C. 1.a9. The Contractor is hiring two (2) nurse coordinators and
   two (2) full time  administrators  with the understanding from the Government
   that the Statement of Work will be changed as follows:

      C. 1.b3.  The Government will provide sheltered on-site parking for all
   Contractors nursing, administrative and laboratory personnel.

      C. 1.b6.  Zit is estimated  that there will be 350 to 450  procedures  per
   year.

      Added:  C. 1.a10. The patients undergoing  intrauterine  insemination will
   be charged an additional  $50.00 for sperm washing prepared by the Contractor
   for each sample.

///////////////////////////////last item////////////////////////////////////////


<PAGE>
                      SUPPLIES OR SERVICES AND PRICES/COSTS

Contractor  to supply all  labor,  materials,  equipment,  and  supervision  for
developing  and  staffing  an  In  Vitro  Fertilization/Gamete  Intra  Fallopian
Transfer  Laboratory  at Walter  Reed Army  Medical  Center.  All work  shall be
performed in accordance  with the Statement of Work and all terms and conditions
of the Contract.
<TABLE>
<CAPTION>

- --------------------------------------------------------------------------------
ITEM       DESCRIPTION                             QUANTITY  U/I     UNIT PRICE        AMOUNT
- ----       -----------                             --------  ---     ----------        ------
<S>        <C>                                      <C>     <C>      <C>              <C>
0001       BASE YEAR
           01 JANUARY 1996 THRU 31 DECEMBER 31

0001AA     BASIC IN VITRO FERTILIZATION (IVF)       300.00    EA      0.000000        0.000000

0001AB     BASIC IVF PLUS INTRACYTOPLASMIC           30.00    EA      0.000000        0.000000
           INJECTION (ICSI)

0001AC     GAMETE INTRAFALLOPIAN TRANSFER (GIFT)     60.00    EA      0.000000        0.000000

0001AD     BASIC IVF PLUS ASSISTED HATCHING         100.00    EA      0.000000        0.000000

0001AE     CRYOPRESERVATION OF EMBRYOS              200.00    EA      0.000000        0.000000

0001AF     STORAGE OF CRYOPRESERVED EMBRYOS         200.00    EA      0.000000        0.000000

0001AG     THAWING OF CRYOPRESERVED EMBRYOS         200.00    EA      0.000000        0.000000

0002       FIRST OPTION PERIOD 1 JANUARY 1997
           THRU 31 DECEMBER 1997

0002AA     BASIC IVF                                300.00    EA      0.000000        0.000000

0002AB     BASIC IVF PLUS INTRACYTOPLASMIC           30.00    EA      0.000000        0.000000
           INJECTION (ICSI)

0002AC     GAMETE INTRAFALLOPIAN TRANSFER (GIFT)     60.00    EA      0.000000        0.000000

0002AD     BASIC IVF PLUS ASSISTED HATCHING         100.00    EA      0.000000        0.000000

0002AE     CRYOPRESERVATION OF EMBRYOS              200.00    EA      0.000000        0.000000

0002AF     STORAGE OF CRYOPRESERVED  EMBRYOS        200.00    EA      0.000000        0.000000

0002AG     THAWING OF CRYOPRESERVED EMBRYOS         200.00    EA      0.000000        0.000000

0003       SECOND OPTION PERIOD 01 JANUARY 1998
           THRU 31 DECEMBER 1998

0003AA     BASIC  IVF                               300.00    EA      0.000000        0.000000

0003AB     BASIC IVF PLUS INTRACYTOPLASMIC           30.00    EA      0.000000        0.000000
           INJECTION (ICSI)

0003AC     GAMETE INTRAFALLOPIAN TRANSFER (GIFT)     60.00    EA      0.000000        0.000000

0003AD     BASIC IVF PLUS ASSISTED HATCHING         100.00    EA      0.000000        0.000000

0003AE     CRYOPRESERVATION OF EMBRYOS              200.00    EA      0.000000        0.000000

0003AF     STORAGE OF CRYOPRESERVED  EMBRYOS        200.00    EA      0.000000        0.000000

0003AG     THAWING OF CRYOPRESERVED EMBRYOS         200.00    EA      0.000000        0.000000

0004       THIRD OPTION PERIOD 01 JANUARY 1999
           THRU 31 DECEMBER 1999

0004AA     BASIC  IVF                               300.00    EA      0.000000        0.000000

0004AB     BASIC IVF PLUS INTRACYTOPLASMIC           30.00     EA      0.000000       0.000000
           INJECTION (ICSI)

0004AC     GAMETE INTRAFALLOPIAN TRANSFER (GIFT)     60.00     EA      0.000000       0.000000

0004AD     BASIC IVF PLUS ASSISTED HATCHING         100.00     EA      0.000000       0.000000

0004AE     CRYOPRESERVATION OF EMBRYOS              200.00     EA      0.000000       0.000000

0004AF     STORAGE OF CRYOPRESERVED  EMBRYOS        200.00     EA      0.000000       0.000000

0004AG     THAWING OF CRYOPRESERVED EMBRYOS         200.00     EA      0.000000       0.000000

</TABLE>


                     AMENDMENT NO. 1 TO MANAGEMENT AGREEMENT

                                     BETWEEN

                       SHADY GROVE FERTILITY CENTERS, INC.

                                       AND

                     LEVY, SAGOSKIN AND STILLMAN, M.D., P.C.



         THIS  AMENDMENT NO. 1 TO MANAGEMENT  AGREEMENT  ("Amendment  No. 1") is
dated  April  16,  1998  by and  among  IntegraMed  America,  Inc.,  a  Delaware
corporation,  with its principal place of business at One  Manhattanville  Road,
Purchase, New York  10577("IntegraMed"),  Shady Grove Fertility Centers, Inc., a
Maryland  corporation,  having a place of business at One  Manhattanville  Road,
Purchase, New York 10577 ("Shady Grove") and Levy, Sagoskin and Stillman,  M.D.,
P.C.,  a Maryland  professional  corporation,  with a place of  business at 9707
Medical Center Drive, Suite 230, Rockville, Maryland 20850 ("PC").

                                    RECITALS:

         WHEREAS,  Shady  Grove  and  PC  entered  into a  Management  Agreement
("Management  Agreement")  dated March 11, 1998  ("Effective  Date") pursuant to
which  Shady  Grove  agreed to provide  certain  management  and  administrative
services to PC for a period of 20 years (the "Term"); and

         WHEREAS,  IntegraMed  acquired the majority of the stock of Shady Grove
on March 12, 1998; and

         WHEREAS,  Shady  Grove and  IntegraMed,  entered  into a  Submanagement
Agreement ("Submanagement  Agreement"),  with PC's consent, dated March 12, 1998
pursuant   to  which   IntegraMed   agreed  to   perform   certain   duties  and
responsibilities of Shady Grove under the Management Agreement; and

         WHEREAS,  PC desires to establish  terms and  conditions  regarding any
expansion  that  Shady  Grove  and/or  IntegraMed  will  make  with  respect  to
management  agreements with other medical  practices  within defined  geographic
limits of PC's medical  offices and Shady Grove and PC are willing to limit such
expansion within defined geographic limits as set forth in this Amendment No. 1;
and

 


<PAGE>



         WHEREAS,  IntegraMed,  is  willing to grant to each of Michael J. Levy,
M.D., Arthur W.Sagoskin,  M.D. and Robert J. Stillman,  M.D., each a stockholder
of PC  ("Stockholders"),  warrants to acquire  15,000 shares,  respectively,  of
IntegraMed  Common Stock (the  "Warrants") at a price equal to the closing price
of  IntegraMed's  Common Stock on the date hereof and with an expiration date of
the  Warrants  that is five  (5)  years  from  the date  hereof;  provided,  the
Stockholders cause PC to amend the Management Agreement so as to extend the Term
to 25 years; and

         WHEREAS,  PC, based on approval of  Stockholders,  is willing to extend
the  Management  Agreement for five (5) years so as to expire  twenty-five  (25)
years from the Effective Date.

         NOW THEREFORE,  in  consideration  of the mutual promises and covenants
herein  contained,   and  as  contained  in  the  Management  and  Submanagement
Agreements, IntegraMed, Shady Grove and PC agree as follows:

         1. The first  sentence of Section 8.2 of The  Management  Agreement  is
hereby deleted and the following sentence is hereby substituted therefor:

                  "The term of this Agreement shall begin on March 11, 1998 (the
                  'Effective  Date')  and shall  expire  twenty-five  (25) years
                  after the Effective Date unless earlier terminated pursuant to
                  Article 9 below."

         2. The Management  Agreement is hereby amended to add the following new
Section 8.3 to Article 8:

                  "8.3  Management  Company  agrees that during the term of this
                  Agreement,  Management  Company  will not  manage  or  provide
                  administrative  services to any other medical practice that is
                  competitive to PC within the geographical area outlined in the
                  territory  established  on the attached  Exhibit 8.3,  without
                  PC's prior written consent."

         3. All other  provisions  of the  Management  Agreement not in conflict
with this Amendment No. 1 remain in full force and effect.

         4. During the Term of the Management Agreement or so long as IntegraMed
owns the majority of the outstanding stock of Shady Grove, IntegraMed agrees not
to manage  any other  medical  practice  that is  competitive  to PC within  the
geographical  area  outlined  in the  territory  set forth in Exhibit 8.3 to the
Management Agreement.

         5. Within 7 days of execution of this  Amendment No. 1 IntegraMed  will
deliver the Warrants to the respective Stockholders.

         6. This  Amendment  No. 1 may be  executed  in any  number of  separate
counterparts,  each of which shall be deemed to be an original, but all of which
together shall constitute one and the same instrument.




<PAGE>


         IN WITNESS  WHEREOF,  the parties have signed this  Amendment No. 1 the
date first above written.


INTEGRAMED AMERICA, INC.


By: /s/Gerardo Canet
    ------------------------
    Gerardo Canet, President


SHADY GROVE FERTILITY CENTERS, INC.


By:  /s/Gerardo Canet
     ------------------------
     Gerardo Canet, President


LEVY, SAGOSKIN AND STILLMAN, M.D., P.C.


By:  /s/ Michael J. Levy, MD
     -------------------------------
     Michael J. Levy, M.D., President


<TABLE> <S> <C>


<ARTICLE>                     5
                  
<MULTIPLIER>                                   1,000
       
<S>                                           <C>
<PERIOD-TYPE>                                  3-mos
<FISCAL-YEAR-END>                              Dec-31-1998
<PERIOD-START>                                 Jan-01-1998
<PERIOD-END>                                   Mar-31-1998
<CASH>                                         2,379
<SECURITIES>                                   0
<RECEIVABLES>                                  13,311
<ALLOWANCES>                                   477
<INVENTORY>                                    0
<CURRENT-ASSETS>                               17,713
<PP&E>                                         5,366<F1>
<DEPRECIATION>                                 0
<TOTAL-ASSETS>                                 48,880
<CURRENT-LIABILITIES>                          10,608
<BONDS>                                        0
                          0
                                    166
<COMMON>                                       213
<OTHER-SE>                                     32,806
<TOTAL-LIABILITY-AND-EQUITY>                   48,880
<SALES>                                        8,746
<TOTAL-REVENUES>                               8,746
<CGS>                                          7,009
<TOTAL-COSTS>                                  7,009
<OTHER-EXPENSES>                               0
<LOSS-PROVISION>                               0
<INTEREST-EXPENSE>                             72
<INCOME-PRETAX>                                259
<INCOME-TAX>                                   49
<INCOME-CONTINUING>                            210
<DISCONTINUED>                                 0
<EXTRAORDINARY>                                0
<CHANGES>                                      0
<NET-INCOME>                                   210
<EPS-PRIMARY>                                  0.01
<EPS-DILUTED>                                  0.01
<FN>
<F1>
PP&E is net of accumulated depreciation.
</FN>


        



</TABLE>


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